- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.86 / $2,278.39 / $8,505.28
| Facility | | $444.86 | $2,278.39 | $8,505.28 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.56 / $2,570.00 / $5,750.14
| Facility | 50 | $0.56 | $2,570.00 | $5,750.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.47 / $320.54 / $605.33
| Professional | | $239.47 | $320.54 | $605.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $217.17 / $454.00 / $966.15
| Professional | 50 | $217.17 | $454.00 | $966.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,709.53 / $5,880.92 / $11,762.27
| Facility | | $2,709.53 | $5,880.92 | $11,762.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.49 / $459.14 / $498.11
| Professional | | $318.49 | $459.14 | $498.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $709.00 / $12,002.00 / $13,106.00
| Facility | | $709.00 | $12,002.00 | $13,106.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.74 / $411.87 / $639.21
| Professional | | $285.74 | $411.87 | $639.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.89 / $450.48 / $1,948.66
| Professional | | $308.89 | $450.48 | $1,948.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.95 / $334.65 / $366.02
| Professional | | $309.95 | $334.65 | $366.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $422.33
| Professional | | $32.34 | $32.34 | $422.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $930.00 / $3,951.00 / $6,625.00
| Facility | | $930.00 | $3,951.00 | $6,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.83 / $408.15 / $646.72
| Professional | | $284.83 | $408.15 | $646.72 |