- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.26 / $2,705.08 / $13,251.72
| Facility | | $288.26 | $2,705.08 | $13,251.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,676.09 / $4,298.35 / $5,784.12
| Facility | 50 | $2,676.09 | $4,298.35 | $5,784.12 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $98.88 / $178.32 / $897.15
| Professional | 50 | $98.88 | $178.32 | $897.15 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $158.81 / $339.42 / $339.42
| Professional | 50 | $158.81 | $339.42 | $339.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $354.87 / $569.66 / $705.63
| Professional | 50 | $354.87 | $569.66 | $705.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.09 / $205.09 / $205.09
| Facility | | $205.09 | $205.09 | $205.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.50 / $1,399.84 / $4,353.18
| Facility | | $0.50 | $1,399.84 | $4,353.18 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $347.65 / $1,455.68 / $2,014.92
| Facility | 50 | $347.65 | $1,455.68 | $2,014.92 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $209.50 / $226.25 / $298.79
| Professional | 50 | $209.50 | $226.25 | $298.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $337.01 / $2,700.00 / $12,771.26
| Facility | | $337.01 | $2,700.00 | $12,771.26 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,676.09 / $4,298.35 / $5,784.12
| Facility | 50 | $2,676.09 | $4,298.35 | $5,784.12 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $98.88 / $404.31 / $897.15
| Professional | 50 | $98.88 | $404.31 | $897.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.09 / $205.09 / $205.09
| Facility | | $205.09 | $205.09 | $205.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.97 / $116.13 / $231.85
| Facility | | $100.97 | $116.13 | $231.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $1,078.00 / $3,742.00
| Facility | | $144.00 | $1,078.00 | $3,742.00 |