- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.50 / $1,470.70 / $3,388.02
| Facility | | $138.50 | $1,470.70 | $3,388.02 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,755.00 / $3,329.20 / $3,442.08
| Facility | 50 | $2,755.00 | $3,329.20 | $3,442.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.53 / $117.91 / $282.70
| Professional | | $64.53 | $117.91 | $282.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.51 / $102.51 / $102.51
| Professional | | $102.51 | $102.51 | $102.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,275.00 / $2,136.00 / $2,838.00
| Facility | | $1,275.00 | $2,136.00 | $2,838.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.97 / $126.99 / $224.75
| Professional | | $71.97 | $126.99 | $224.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.00 / $162.35 / $273.36
| Professional | | $95.00 | $162.35 | $273.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $582.48 / $594.72 / $12,000.00
| Facility | | $582.48 | $594.72 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,100.00 / $1,242.72 / $1,436.85
| Professional | | $1,100.00 | $1,242.72 | $1,436.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,128.00 / $2,297.00 / $4,326.00
| Facility | | $1,128.00 | $2,297.00 | $4,326.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.62 / $182.31 / $286.97
| Professional | | $117.62 | $182.31 | $286.97 |