- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.06 / $2,079.00 / $3,625.00
| Facility | | $89.06 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $307.31 / $307.31 / $307.31
| Facility | 50 | $307.31 | $307.31 | $307.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.68 / $73.53 / $133.32
| Professional | | $47.68 | $73.53 | $133.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $941.10 / $2,796.00
| Facility | | $55.00 | $941.10 | $2,796.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.31 / $116.47 / $354.32
| Professional | | $53.31 | $116.47 | $354.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.82 / $69.16 / $123.46
| Facility | | $53.82 | $69.16 | $123.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.23 / $108.79 / $191.05
| Professional | | $63.23 | $108.79 | $191.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.73 / $168.26 / $6,679.00
| Facility | | $55.73 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.51 / $97.52 / $132.69
| Professional | | $80.51 | $97.52 | $132.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.03 / $127.68 / $194.94
| Professional | | $60.03 | $127.68 | $194.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.43 / $0.43 / $0.43
| Facility | | $0.43 | $0.43 | $0.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.03 / $148.86 / $824.00
| Professional | | $89.03 | $148.86 | $824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.96 / $119.84 / $227.05
| Professional | | $83.96 | $119.84 | $227.05 |