- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.30 / $2,946.56 / $12,765.09
| Facility | | $247.30 | $2,946.56 | $12,765.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.15 / $259.31 / $640.67
| Professional | | $120.15 | $259.31 | $640.67 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $171.84 / $171.84 / $171.84
| Professional | 50 | $171.84 | $171.84 | $171.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.14 / $288.14 / $288.14
| Professional | | $288.14 | $288.14 | $288.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,507.81 / $1,983.18 / $3,836.12
| Facility | | $1,507.81 | $1,983.18 | $3,836.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.61 / $258.93 / $505.25
| Professional | | $128.61 | $258.93 | $505.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.91 / $716.91 / $716.91
| Facility | | $716.91 | $716.91 | $716.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.05 / $497.74 / $708.95
| Professional | | $245.05 | $497.74 | $708.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.22 / $325.27 / $1,317.94
| Facility | | $143.22 | $325.27 | $1,317.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.87 / $517.44 / $1,262.00
| Professional | | $312.87 | $517.44 | $1,262.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.30 / $576.41 / $921.98
| Facility | | $285.30 | $576.41 | $921.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.43 / $473.73 / $693.85
| Professional | | $275.43 | $473.73 | $693.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.92 / $266.08 / $948.71
| Professional | | $125.92 | $266.08 | $948.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.00 / $3,227.00 / $6,169.00
| Facility | | $1,775.00 | $3,227.00 | $6,169.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.87 / $496.39 / $646.78
| Professional | | $312.87 | $496.39 | $646.78 |