- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.07 / $427.14 / $2,042.00
| Facility | | $50.07 | $427.14 | $2,042.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.07 / $330.76 / $612.05
| Professional | | $50.07 | $330.76 | $612.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $452.33 / $1,107.66 / $2,427.64
| Facility | | $452.33 | $1,107.66 | $2,427.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,557.64 / $2,363.28 / $4,143.79
| Facility | 50 | $1,557.64 | $2,363.28 | $4,143.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.28 / $371.28 / $1,390.52
| Professional | | $95.28 | $371.28 | $1,390.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,046.08 / $1,483.49 / $3,568.73
| Facility | | $1,046.08 | $1,483.49 | $3,568.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.63 / $354.53 / $1,722.17
| Professional | | $124.63 | $354.53 | $1,722.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $850.40 / $1,356.26 / $2,810.03
| Facility | | $850.40 | $1,356.26 | $2,810.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.13 / $379.69 / $1,496.25
| Professional | | $109.13 | $379.69 | $1,496.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.62 / $683.39 / $1,755.00
| Facility | | $84.62 | $683.39 | $1,755.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $451.91 / $1,074.26 / $1,627.52
| Professional | | $451.91 | $1,074.26 | $1,627.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $976.00 / $1,947.00 / $4,195.00
| Facility | | $976.00 | $1,947.00 | $4,195.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.04 / $1,074.50 / $1,558.73
| Professional | | $457.04 | $1,074.50 | $1,558.73 |