- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.73 / $233.55 / $2,064.00
| Facility | | $79.73 | $233.55 | $2,064.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.51 / $197.62 / $325.45
| Professional | | $74.51 | $197.62 | $325.45 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $298.08 / $298.85 / $298.85
| Professional | 50 | $298.08 | $298.85 | $298.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.51 / $1,179.08 / $2,457.60
| Facility | | $296.51 | $1,179.08 | $2,457.60 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,576.86 / $2,392.44 / $4,194.93
| Facility | 50 | $1,576.86 | $2,392.44 | $4,194.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.74 / $356.09 / $778.33
| Professional | | $157.74 | $356.09 | $778.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $232.67 / $498.68 / $1,167.50
| Professional | 50 | $232.67 | $498.68 | $1,167.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.34 / $820.58 / $1,974.01
| Facility | | $578.34 | $820.58 | $1,974.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.88 / $410.26 / $924.12
| Professional | | $174.88 | $410.26 | $924.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.39 / $750.20 / $1,554.34
| Facility | | $470.39 | $750.20 | $1,554.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.15 / $340.47 / $776.79
| Professional | | $173.15 | $340.47 | $776.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.37 / $239.22 / $700.66
| Facility | | $111.37 | $239.22 | $700.66 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,945.05 / $4,945.05 / $4,945.05
| Facility | 50 | $4,945.05 | $4,945.05 | $4,945.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.31 / $427.82 / $862.40
| Professional | | $231.31 | $427.82 | $862.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,187.00 / $2,872.00 / $4,241.00
| Facility | | $1,187.00 | $2,872.00 | $4,241.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.42 / $399.08 / $810.32
| Professional | | $229.42 | $399.08 | $810.32 |