- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $167.21 / $2,747.00 / $10,632.00
| Facility | | $167.21 | $2,747.00 | $10,632.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,042.58 / $1,092.43 / $1,535.00
| Facility | 50 | $1,042.58 | $1,092.43 | $1,535.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.33 / $167.21 / $259.56
| Professional | | $70.33 | $167.21 | $259.56 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $120.47 / $120.47 / $1,659.12
| Professional | 50 | $120.47 | $120.47 | $1,659.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.15 / $195.15 / $195.15
| Professional | | $195.15 | $195.15 | $195.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $370.55 / $441.13
| Facility | | $323.00 | $370.55 | $441.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.17 / $167.07 / $358.64
| Professional | | $78.17 | $167.07 | $358.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,104.00 / $3,158.00 / $7,922.00
| Facility | | $2,104.00 | $3,158.00 | $7,922.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.05 / $190.10 / $243.75
| Professional | | $95.05 | $190.10 | $243.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.00 / $251.42 / $386.05
| Professional | | $175.00 | $251.42 | $386.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591.00 / $2,671.00 / $6,077.00
| Facility | | $591.00 | $2,671.00 | $6,077.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.81 / $220.47 / $377.82
| Professional | | $155.81 | $220.47 | $377.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.81 / $171.58 / $171.58
| Professional | | $62.81 | $171.58 | $171.58 |