- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.65 / $4,280.34 / $8,031.00
| Facility | | $224.65 | $4,280.34 | $8,031.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,367.08 / $6,367.08 / $6,367.08
| Facility | 50 | $6,367.08 | $6,367.08 | $6,367.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.27 / $127.39 / $224.65
| Professional | | $56.27 | $127.39 | $224.65 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $236.92 / $460.35 / $4,783.50
| Professional | 50 | $236.92 | $460.35 | $4,783.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,410.00 / $6,763.00 / $10,432.00
| Facility | | $5,410.00 | $6,763.00 | $10,432.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.43 / $108.13 / $205.94
| Professional | | $56.43 | $108.13 | $205.94 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $84.64 / $162.16 / $308.91
| Professional | 50 | $84.64 | $162.16 | $308.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.00 / $1,309.52 / $1,309.52
| Facility | | $550.00 | $1,309.52 | $1,309.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.17 / $164.42 / $301.92
| Professional | | $94.17 | $164.42 | $301.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,340.80 / $1,643.00 / $1,677.00
| Facility | | $1,340.80 | $1,643.00 | $1,677.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.63 / $194.37 / $218.03
| Professional | | $83.63 | $194.37 | $218.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,459.86 / $1,459.86 / $1,459.86
| Facility | | $1,459.86 | $1,459.86 | $1,459.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,157.00 / $4,210.00 / $7,760.00
| Facility | | $1,157.00 | $4,210.00 | $7,760.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.06 / $175.65 / $311.36
| Professional | | $83.06 | $175.65 | $311.36 |