- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.00 / $1,725.57 / $3,363.00
| Facility | | $254.00 | $1,725.57 | $3,363.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,058.81 / $1,058.81 / $1,058.81
| Facility | 50 | $1,058.81 | $1,058.81 | $1,058.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.95 / $167.46 / $560.82
| Professional | | $87.95 | $167.46 | $560.82 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $264.62 / $871.52 / $1,279.50
| Professional | 50 | $264.62 | $871.52 | $1,279.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.16 / $818.35 / $11,500.00
| Facility | | $177.16 | $818.35 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.09 / $271.20 / $940.34
| Professional | | $78.09 | $271.20 | $940.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.34 / $108.34 / $212.52
| Facility | | $83.34 | $108.34 | $212.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.51 / $306.36 / $523.19
| Professional | | $127.51 | $306.36 | $523.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.74 / $331.05 / $596.85
| Professional | | $128.74 | $331.05 | $596.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $300.00 / $6,679.00
| Facility | | $83.43 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.26 / $288.39 / $494.31
| Professional | | $242.26 | $288.39 | $494.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.34 / $242.89 / $565.92
| Professional | | $91.34 | $242.89 | $565.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.94 / $273.57 / $306.89
| Professional | | $156.94 | $273.57 | $306.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $351.60 / $2,028.00 / $11,500.00
| Facility | | $351.60 | $2,028.00 | $11,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.74 / $474.83 / $1,412.32
| Professional | | $229.74 | $474.83 | $1,412.32 |
- 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
- $205.25 / $306.94 / $940.34
| Professional | | $205.25 | $306.94 | $940.34 |