- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.37 / $2,551.00 / $6,805.75
| Facility | | $190.37 | $2,551.00 | $6,805.75 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $813.00 / $1,672.50 / $4,157.10
| Facility | 50 | $813.00 | $1,672.50 | $4,157.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.67 / $175.66 / $297.75
| Professional | | $102.67 | $175.66 | $297.75 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $154.01 / $537.20 / $951.17
| Professional | 50 | $154.01 | $537.20 | $951.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,974.00 / $2,971.00 / $7,022.00
| Facility | | $1,974.00 | $2,971.00 | $7,022.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.71 / $147.44 / $232.71
| Professional | | $112.71 | $147.44 | $232.71 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $131.94 / $165.27 / $217.26
| Professional | 50 | $131.94 | $165.27 | $217.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $684.56 / $684.56 / $2,156.40
| Facility | | $684.56 | $684.56 | $2,156.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.49 / $210.30 / $336.92
| Professional | | $127.49 | $210.30 | $336.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.11 / $190.38 / $308.86
| Facility | | $114.11 | $190.38 | $308.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.86 / $213.45 / $380.75
| Professional | | $134.86 | $213.45 | $380.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,361.00 / $2,537.00 / $3,681.00
| Facility | | $1,361.00 | $2,537.00 | $3,681.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.25 / $302.39 / $460.71
| Professional | | $208.25 | $302.39 | $460.71 |