- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,227.00 / $2,669.00 / $5,048.00
| Facility | | $1,227.00 | $2,669.00 | $5,048.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $697.75 / $2,018.60 / $7,905.00
| Facility | 50 | $697.75 | $2,018.60 | $7,905.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.66 / $533.34 / $1,508.87
| Professional | | $363.66 | $533.34 | $1,508.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.35 / $3,997.00 / $12,729.53
| Facility | | $818.35 | $3,997.00 | $12,729.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.36 / $693.49 / $5,068.89
| Professional | | $346.36 | $693.49 | $5,068.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.99 / $702.77 / $1,273.70
| Professional | | $466.99 | $702.77 | $1,273.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.06 / $730.10 / $6,679.00
| Facility | | $344.06 | $730.10 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.04 / $403.38 / $636.51
| Professional | | $212.04 | $403.38 | $636.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.49 / $858.57 / $1,293.65
| Professional | | $430.49 | $858.57 | $1,293.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,350.19 / $4,108.97 / $7,325.86
| Facility | | $2,350.19 | $4,108.97 | $7,325.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.70 / $546.53 / $696.60
| Professional | | $307.70 | $546.53 | $696.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $4,525.00 / $26,542.00
| Facility | | $1,902.00 | $4,525.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.36 / $730.10 / $5,068.89
| Professional | | $396.36 | $730.10 | $5,068.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.00 / $545.92 / $1,323.87
| Professional | | $396.00 | $545.92 | $1,323.87 |