- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.86 / $988.00 / $2,747.00
| Facility | | $92.86 | $988.00 | $2,747.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $299.52 / $1,281.56 / $1,924.23
| Facility | 50 | $299.52 | $1,281.56 | $1,924.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.93 / $88.82 / $218.91
| Professional | | $48.93 | $88.82 | $218.91 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $83.87 / $262.77 / $708.40
| Professional | 50 | $83.87 | $262.77 | $708.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.18 / $740.00 / $2,733.00
| Facility | | $118.18 | $740.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.09 / $138.74 / $483.00
| Professional | | $60.09 | $138.74 | $483.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.98 / $74.50 / $140.53
| Facility | | $57.98 | $74.50 | $140.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.78 / $108.94 / $242.01
| Professional | | $23.78 | $108.94 | $242.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.98 / $126.39 / $226.26
| Professional | | $67.98 | $126.39 | $226.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.07 / $79.29 / $6,679.00
| Facility | | $32.07 | $79.29 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.50 / $126.63 / $174.80
| Professional | | $104.50 | $126.63 | $174.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.82 / $137.41 / $246.77
| Professional | | $63.82 | $137.41 | $246.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.54 / $865.54 / $2,064.48
| Facility | | $214.54 | $865.54 | $2,064.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.12 / $155.78 / $233.67
| Professional | | $79.12 | $155.78 | $233.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.76 / $966.90 / $3,445.00
| Facility | | $247.76 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.21 / $192.04 / $1,800.00
| Professional | | $106.21 | $192.04 | $1,800.00 |
- 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
- $105.01 / $169.22 / $258.12
| Professional | | $105.01 | $169.22 | $258.12 |