- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.12 / $1,886.00 / $3,625.00
| Facility | | $124.12 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $408.37 / $408.37 / $1,109.18
| Facility | 50 | $408.37 | $408.37 | $1,109.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.89 / $108.76 / $196.49
| Professional | | $52.89 | $108.76 | $196.49 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $364.85 / $593.49 / $646.98
| Professional | 50 | $364.85 | $593.49 | $646.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.62 / $536.38 / $2,713.00
| Facility | | $72.62 | $536.38 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.83 / $127.29 / $1,017.00
| Professional | | $50.83 | $127.29 | $1,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.34 / $67.26 / $126.14
| Facility | | $52.34 | $67.26 | $126.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.05 / $123.49 / $233.55
| Professional | | $66.05 | $123.49 | $233.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.05 / $292.60 / $6,679.00
| Facility | | $53.05 | $292.60 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.29 / $113.67 / $156.90
| Professional | | $93.29 | $113.67 | $156.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.50 / $123.40 / $239.17
| Professional | | $58.50 | $123.40 | $239.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.32 / $179.06 / $1,017.00
| Professional | | $85.32 | $179.06 | $1,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.32 / $174.93 / $310.00
| Professional | | $85.32 | $174.93 | $310.00 |