- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.76 / $2,747.00 / $10,632.00
| Facility | | $77.76 | $2,747.00 | $10,632.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.56 / $0.56 / $3,357.75
| Facility | 50 | $0.56 | $0.56 | $3,357.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.38 / $120.34 / $169.98
| Professional | | $74.38 | $120.34 | $169.98 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $120.12 / $120.12 / $1,222.02
| Professional | 50 | $120.12 | $120.12 | $1,222.02 |
- 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
- $78.48 / $136.08 / $253.03
| Professional | | $78.48 | $136.08 | $253.03 |
- 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
- $67.80 / $126.83 / $163.05
| Professional | | $67.80 | $126.83 | $163.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.40 / $142.11 / $216.49
| Professional | | $100.40 | $142.11 | $216.49 |
- 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
- $102.80 / $150.26 / $244.13
| Professional | | $102.80 | $150.26 | $244.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.98 / $101.36 / $101.36
| Professional | | $58.98 | $101.36 | $101.36 |