- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $2,754.23 / $11,220.18
| Facility | | $288.40 | $2,754.23 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,348.96 / $4,265.80 / $5,754.40
| Facility | 50 | $1,348.96 | $4,265.80 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $123.03 / $446.68 / $977.24
| Professional | 50 | $123.03 | $446.68 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $154.88 / $154.88 / $165.96
| Professional | 50 | $154.88 | $154.88 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $354.81 / $371.54 / $707.95
| Professional | 50 | $354.81 | $371.54 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $204.17 / $204.17
| Facility | | $204.17 | $204.17 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.50 / $851.14 / $19,054.61
| Facility | | $0.50 | $851.14 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $346.74 / $1,445.44 / $2,137.96
| Facility | 50 | $346.74 | $1,445.44 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $208.93 / $223.87 / $245.47
| Professional | 50 | $208.93 | $223.87 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $2,398.83 / $9,549.93
| Facility | | $346.74 | $2,398.83 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,290.87 / $4,265.80 / $8,317.64
| Facility | 50 | $2,290.87 | $4,265.80 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $147.91 / $457.09 / $1,122.02
| Professional | 50 | $147.91 | $457.09 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $223.87 / $1,584.89
| Facility | | $100.00 | $223.87 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $676.08 / $4,265.80
| Facility | | $144.54 | $676.08 | $4,265.80 |