- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.11 / $1,886.00 / $3,625.00
| Facility | | $150.11 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,228.15 / $1,228.15 / $1,228.15
| Facility | 50 | $1,228.15 | $1,228.15 | $1,228.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.38 / $120.58 / $224.65
| Professional | | $70.38 | $120.58 | $224.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.04 / $1,483.60 / $7,161.00
| Facility | | $127.04 | $1,483.60 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.51 / $155.56 / $1,087.00
| Professional | | $61.51 | $155.56 | $1,087.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.18 / $81.19 / $151.63
| Facility | | $63.18 | $81.19 | $151.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.06 / $147.03 / $279.04
| Professional | | $77.06 | $147.03 | $279.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.37 / $281.86 / $6,679.00
| Facility | | $64.37 | $281.86 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.48 / $136.63 / $188.60
| Professional | | $112.48 | $136.63 | $188.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.95 / $149.69 / $288.38
| Professional | | $70.95 | $149.69 | $288.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,021.39 / $1,021.39 / $1,718.81
| Facility | | $1,021.39 | $1,021.39 | $1,718.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.90 / $131.37 / $155.22
| Professional | | $108.90 | $131.37 | $155.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $292.89 / $2,078.00 / $12,000.00
| Facility | | $292.89 | $2,078.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.30 / $226.46 / $1,087.00
| Professional | | $111.30 | $226.46 | $1,087.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.10 / $183.01 / $360.92
| Professional | | $104.10 | $183.01 | $360.92 |