- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $1,659.59 / $7,079.46
| Facility | | $123.03 | $1,659.59 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,000.00 / $1,905.46 / $8,912.51
| Facility | 50 | $1,000.00 | $1,905.46 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $123.03 / $371.54
| Professional | | $61.66 | $123.03 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $537.03 / $537.03 / $549.54
| Professional | 50 | $537.03 | $537.03 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $3,630.78 / $8,709.64
| Facility | | $1,445.44 | $3,630.78 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $100.00 / $208.93
| Professional | | $61.66 | $100.00 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $91.20 / $151.36 / $309.03
| Professional | 50 | $91.20 | $151.36 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $398.11 / $1,202.26
| Facility | | $120.23 | $398.11 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $141.25 / $309.03
| Professional | | $74.13 | $141.25 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $1,949.84 / $4,786.30
| Facility | | $645.65 | $1,949.84 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $112.20 / $223.87
| Professional | | $60.26 | $112.20 | $223.87 |