- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,069.00 / $2,663.12 / $4,410.00
| Facility | | $1,069.00 | $2,663.12 | $4,410.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $374.23 / $747.99 / $1,989.92
| Facility | 50 | $374.23 | $747.99 | $1,989.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.04 / $472.04 / $4,273.78
| Professional | | $153.04 | $472.04 | $4,273.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $433.55 / $4,402.00 / $11,266.45
| Facility | | $433.55 | $4,402.00 | $11,266.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.27 / $3,664.32 / $19,483.16
| Professional | | $210.27 | $3,664.32 | $19,483.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $207.66 / $269.95 / $529.53
| Facility | | $207.66 | $269.95 | $529.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.54 / $340.54 / $3,295.56
| Professional | | $340.54 | $340.54 | $3,295.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.27 / $810.13 / $5,988.48
| Professional | | $281.27 | $810.13 | $5,988.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.23 / $283.98 / $6,679.00
| Facility | | $177.23 | $283.98 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,874.34 / $2,381.81 / $4,234.62
| Professional | | $1,874.34 | $2,381.81 | $4,234.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.13 / $1,959.53 / $4,350.35
| Professional | | $227.13 | $1,959.53 | $4,350.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $5,268.00 / $9,401.00
| Facility | | $2,155.00 | $5,268.00 | $9,401.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,632.96 / $6,268.24 / $19,483.16
| Professional | | $2,632.96 | $6,268.24 | $19,483.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,339.23 / $4,232.62 / $7,310.95
| Professional | | $2,339.23 | $4,232.62 | $7,310.95 |