- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.65 / $4,761.00 / $13,274.33
| Facility | | $531.65 | $4,761.00 | $13,274.33 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,466.00 / $13,444.40 / $31,796.76
| Facility | 50 | $4,466.00 | $13,444.40 | $31,796.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.09 / $489.53 / $972.61
| Professional | | $385.09 | $489.53 | $972.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.32 / $342.32 / $342.32
| Professional | | $342.32 | $342.32 | $342.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.00 / $7,463.00 / $11,048.00
| Facility | | $2,800.00 | $7,463.00 | $11,048.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.74 / $655.40 / $965.30
| Professional | | $459.74 | $655.40 | $965.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $434.66 / $583.83 / $983.55
| Professional | | $434.66 | $583.83 | $983.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $626.66 / $834.08 / $834.08
| Professional | | $626.66 | $834.08 | $834.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,085.59 / $10,150.86 / $22,913.33
| Facility | | $3,085.59 | $10,150.86 | $22,913.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $448.60 / $463.23 / $517.19
| Professional | | $448.60 | $463.23 | $517.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $631.33 / $3,839.00 / $9,761.17
| Facility | | $631.33 | $3,839.00 | $9,761.17 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,466.00 / $13,444.40 / $31,796.76
| Facility | 50 | $4,466.00 | $13,444.40 | $31,796.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $387.00 / $583.05 / $1,226.99
| Professional | | $387.00 | $583.05 | $1,226.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.40 / $644.88 / $1,050.11
| Professional | | $377.40 | $644.88 | $1,050.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.26 / $606.74 / $983.55
| Professional | | $446.26 | $606.74 | $983.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.61 / $443.73 / $526.27
| Facility | | $410.61 | $443.73 | $526.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $410.61 / $502.24 / $549.48
| Professional | | $410.61 | $502.24 | $549.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $454.02 / $634.53 / $1,028.90
| Professional | | $454.02 | $634.53 | $1,028.90 |