- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.19 / $1,886.00 / $3,625.00
| Facility | | $530.19 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $609.82 / $3,156.06 / $5,461.68
| Facility | 50 | $609.82 | $3,156.06 | $5,461.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.49 / $341.60 / $1,042.89
| Professional | | $106.49 | $341.60 | $1,042.89 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $145.16 / $512.40 / $3,021.90
| Professional | 50 | $145.16 | $512.40 | $3,021.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.10 / $1,275.80 / $3,804.00
| Facility | | $217.10 | $1,275.80 | $3,804.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.44 / $827.96 / $2,683.89
| Professional | | $109.44 | $827.96 | $2,683.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.91 / $146.78 / $288.49
| Facility | | $112.91 | $146.78 | $288.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.37 / $225.37 / $1,424.84
| Professional | | $225.37 | $225.37 | $1,424.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.03 / $519.65 / $1,731.82
| Professional | | $148.03 | $519.65 | $1,731.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.71 / $205.88 / $6,679.00
| Facility | | $98.71 | $205.88 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.91 / $668.29 / $1,077.42
| Professional | | $371.91 | $668.29 | $1,077.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.43 / $700.01 / $1,550.52
| Professional | | $123.43 | $700.01 | $1,550.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.92 / $2,059.58 / $4,578.51
| Facility | | $117.92 | $2,059.58 | $4,578.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.25 / $153.01 / $220.05
| Professional | | $72.25 | $153.01 | $220.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,878.00 / $7,161.00
| Facility | | $55.00 | $1,878.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $677.87 / $1,301.61 / $4,093.84
| Professional | | $677.87 | $1,301.61 | $4,093.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $655.79 / $944.41 / $3,019.61
| Professional | | $655.79 | $944.41 | $3,019.61 |