- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.93 / $72.29 / $2,042.00
| Facility | | $48.93 | $72.29 | $2,042.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.93 / $80.78 / $386.26
| Professional | | $48.93 | $80.78 | $386.26 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $52.01 / $278.00 / $1,112.93
| Professional | 50 | $52.01 | $278.00 | $1,112.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $384.92 / $954.52 / $2,491.42
| Facility | | $384.92 | $954.52 | $2,491.42 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $675.36 / $1,024.66 / $1,796.66
| Facility | 50 | $675.36 | $1,024.66 | $1,796.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.01 / $170.43 / $266.29
| Professional | | $98.01 | $170.43 | $266.29 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $144.80 / $244.77 / $387.45
| Professional | 50 | $144.80 | $244.77 | $387.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.99 / $256.80 / $617.78
| Facility | | $180.99 | $256.80 | $617.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.91 / $179.12 / $309.33
| Professional | | $105.91 | $179.12 | $309.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $164.54 / $234.78 / $486.44
| Facility | | $164.54 | $234.78 | $486.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.54 / $163.85 / $282.06
| Professional | | $102.54 | $163.85 | $282.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.34 / $116.79 / $409.61
| Facility | | $69.34 | $116.79 | $409.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $489.00 / $1,381.16 / $1,765.70
| Facility | 50 | $489.00 | $1,381.16 | $1,765.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.27 / $164.66 / $288.38
| Professional | | $84.27 | $164.66 | $288.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.00 / $1,580.95 / $3,584.00
| Facility | | $563.00 | $1,580.95 | $3,584.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.18 / $158.62 / $280.04
| Professional | | $82.18 | $158.62 | $280.04 |