- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.78 / $1,803.00 / $3,363.00
| Facility | | $205.78 | $1,803.00 | $3,363.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $232.50 / $2,105.79 / $4,095.59
| Facility | 50 | $232.50 | $2,105.79 | $4,095.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.34 / $183.25 / $313.39
| Professional | | $101.34 | $183.25 | $313.39 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $207.19 / $278.77 / $1,145.55
| Professional | 50 | $207.19 | $278.77 | $1,145.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.81 / $1,483.60 / $7,161.00
| Facility | | $244.81 | $1,483.60 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.90 / $307.30 / $1,012.00
| Professional | | $124.90 | $307.30 | $1,012.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.37 / $157.25 / $300.29
| Facility | | $122.37 | $157.25 | $300.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.74 / $294.00 / $594.79
| Professional | | $145.74 | $294.00 | $594.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.47 / $262.95 / $481.26
| Professional | | $143.47 | $262.95 | $481.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $106.49 / $300.00 / $6,679.00
| Facility | | $106.49 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.19 / $270.58 / $373.52
| Professional | | $222.19 | $270.58 | $373.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.90 / $286.69 / $566.94
| Professional | | $135.90 | $286.69 | $566.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $923.25 / $1,891.03 / $3,704.58
| Facility | | $923.25 | $1,891.03 | $3,704.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.80 / $327.02 / $701.89
| Professional | | $246.80 | $327.02 | $701.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.02 / $2,078.00 / $30,000.00
| Facility | | $524.02 | $2,078.00 | $30,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.30 / $462.20 / $3,500.00
| Professional | | $234.30 | $462.20 | $3,500.00 |
- 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
- $220.00 / $370.27 / $601.86
| Professional | | $220.00 | $370.27 | $601.86 |