- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $2,222.50 / $5,506.00
| Facility | | $627.00 | $2,222.50 | $5,506.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.62 / $3,049.93 / $9,079.12
| Facility | 50 | $0.62 | $3,049.93 | $9,079.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.78 / $822.48 / $1,357.41
| Professional | | $172.78 | $822.48 | $1,357.41 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $876.25 / $1,144.56 / $1,287.27
| Professional | 50 | $876.25 | $1,144.56 | $1,287.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.41 / $345.41 / $345.41
| Professional | | $345.41 | $345.41 | $345.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.13 / $314.82 / $518.16
| Facility | | $86.13 | $314.82 | $518.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.49 / $548.76 / $897.97
| Professional | | $170.49 | $548.76 | $897.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.87 / $481.63 / $1,262.48
| Professional | | $176.87 | $481.63 | $1,262.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $195.11 / $828.63 / $1,749.11
| Facility | | $195.11 | $828.63 | $1,749.11 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,922.15 / $7,922.15 / $7,922.15
| Facility | 50 | $7,922.15 | $7,922.15 | $7,922.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $802.54 / $985.98 / $6,036.72
| Professional | | $802.54 | $985.98 | $6,036.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $631.00 / $1,535.00 / $2,175.00
| Facility | | $631.00 | $1,535.00 | $2,175.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $801.92 / $932.90 / $1,406.54
| Professional | | $801.92 | $932.90 | $1,406.54 |