- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $1,288.25 / $3,715.35
| Facility | | $269.15 | $1,288.25 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $831.76 / $2,454.71 / $3,981.07
| Facility | 50 | $831.76 | $2,454.71 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $199.53 / $1,071.52
| Professional | | $102.33 | $199.53 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $213.80 / $338.84 / $5,754.40
| Professional | 50 | $213.80 | $338.84 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $123.03 / $199.53
| Professional | | $85.11 | $123.03 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $131.83 / $177.83 / $288.40
| Professional | 50 | $131.83 | $177.83 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $1,230.27 / $1,949.84
| Facility | | $407.38 | $1,230.27 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $181.97 / $295.12
| Professional | | $109.65 | $181.97 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $1,000.00 / $1,000.00
| Facility | | $39.81 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $398.11
| Facility | | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $186.21 / $309.03
| Professional | | $112.20 | $186.21 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $1,096.48 / $2,344.23
| Facility | | $338.84 | $1,096.48 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $177.83 / $331.13
| Professional | | $95.50 | $177.83 | $331.13 |