- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $1,584.89 / $2,238.72
| Facility | | $275.42 | $1,584.89 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $9,772.37 / $9,772.37 / $9,772.37
| Facility | 50 | $9,772.37 | $9,772.37 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $457.09 / $1,000.00
| Professional | | $275.42 | $457.09 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $302.00 / $363.08
| Professional | | $165.96 | $302.00 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $323.59 / $323.59
| Facility | | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.25 / $891.25 / $891.25
| Professional | | $891.25 | $891.25 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $3,801.89
| Facility | | $213.80 | $213.80 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $645.65 / $1,096.48
| Professional | | $338.84 | $645.65 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,235.94 / $7,244.36
| Facility | | $851.14 | $3,235.94 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $549.54 / $1,023.29
| Professional | | $281.84 | $549.54 | $1,023.29 |