- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.92 / $1,955.89 / $7,802.23
| Facility | | $76.92 | $1,955.89 | $7,802.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.54 / $178.84 / $799.00
| Professional | | $73.54 | $178.84 | $799.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $439.76 / $439.76 / $439.76
| Professional | 50 | $439.76 | $439.76 | $439.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,137.03 / $4,575.71 / $10,098.06
| Facility | | $1,137.03 | $4,575.71 | $10,098.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.87 / $285.18 / $598.54
| Professional | | $133.87 | $285.18 | $598.54 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $200.81 / $405.50 / $897.81
| Professional | 50 | $200.81 | $405.50 | $897.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.87 / $629.47 / $1,514.27
| Facility | | $443.87 | $629.47 | $1,514.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.18 / $362.23 / $752.46
| Professional | | $169.18 | $362.23 | $752.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.84 / $575.48 / $1,192.33
| Facility | | $360.84 | $575.48 | $1,192.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.41 / $296.23 / $653.75
| Professional | | $156.41 | $296.23 | $653.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.99 / $731.67 / $3,500.00
| Facility | | $129.99 | $731.67 | $3,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.00 / $490.84 / $712.20
| Professional | | $242.00 | $490.84 | $712.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,296.00 / $3,500.00 / $6,361.00
| Facility | | $2,296.00 | $3,500.00 | $6,361.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.93 / $425.28 / $688.16
| Professional | | $227.93 | $425.28 | $688.16 |