- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.54 / $2,079.00 / $3,625.00
| Facility | | $158.54 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $487.62 / $487.62 / $487.62
| Facility | 50 | $487.62 | $487.62 | $487.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.33 / $130.86 / $226.54
| Professional | | $76.33 | $130.86 | $226.54 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $294.00 / $294.00 / $1,276.26
| Professional | 50 | $294.00 | $294.00 | $1,276.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.10 / $1,177.70 / $3,472.00
| Facility | | $122.10 | $1,177.70 | $3,472.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.89 / $203.72 / $568.40
| Professional | | $91.89 | $203.72 | $568.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.76 / $111.49 / $202.87
| Facility | | $86.76 | $111.49 | $202.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.72 / $188.43 / $344.74
| Professional | | $101.72 | $188.43 | $344.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $168.26 / $6,679.00
| Facility | | $83.43 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.91 / $184.02 / $252.33
| Professional | | $151.91 | $184.02 | $252.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.35 / $209.58 / $390.75
| Professional | | $99.35 | $209.58 | $390.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,446.95 / $3,446.95 / $3,446.95
| Facility | | $3,446.95 | $3,446.95 | $3,446.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,600.00 / $7,161.00
| Facility | | $55.00 | $1,600.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.31 / $265.37 / $964.40
| Professional | | $159.31 | $265.37 | $964.40 |
- 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
- $150.59 / $240.11 / $409.75
| Professional | | $150.59 | $240.11 | $409.75 |