- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.52 / $1,886.00 / $3,625.00
| Facility | | $235.52 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,264.48 / $1,264.48 / $1,264.48
| Facility | 50 | $1,264.48 | $1,264.48 | $1,264.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.53 / $146.79 / $434.54
| Professional | | $44.53 | $146.79 | $434.54 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $220.19 / $220.19 / $220.19
| Professional | 50 | $220.19 | $220.19 | $220.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.77 / $627.00 / $2,733.00
| Facility | | $102.77 | $627.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.50 / $468.97 / $2,278.06
| Professional | | $57.50 | $468.97 | $2,278.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.51 / $66.64 / $120.46
| Facility | | $52.51 | $66.64 | $120.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.62 / $299.68 / $537.90
| Professional | | $73.62 | $299.68 | $537.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.93 / $161.85 / $723.38
| Professional | | $57.93 | $161.85 | $723.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.93 / $168.26 / $6,679.00
| Facility | | $53.93 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.20 / $368.20 / $635.32
| Professional | | $281.20 | $368.20 | $635.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.94 / $241.15 / $679.59
| Professional | | $65.94 | $241.15 | $679.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.12 / $139.12 / $723.70
| Facility | | $139.12 | $139.12 | $723.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.42 / $72.84 / $159.00
| Professional | | $36.42 | $72.84 | $159.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.00 / $953.00 / $2,796.00
| Facility | | $308.00 | $953.00 | $2,796.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.18 / $687.34 / $2,278.06
| Professional | | $326.18 | $687.34 | $2,278.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.60 / $517.53 / $905.55
| Professional | | $304.60 | $517.53 | $905.55 |