- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,398.83 / $9,772.37
| Facility | | $1,819.70 | $2,398.83 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,344.23 / $2,344.23 / $2,344.23
| Facility | 50 | $2,344.23 | $2,344.23 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $87.10 / $165.96
| Professional | | $52.48 | $87.10 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $234.42 / $380.19 / $630.96
| Professional | 50 | $234.42 | $380.19 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $100.00 / $141.25
| Professional | | $44.67 | $100.00 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $67.61 / $151.36 / $208.93
| Professional | 50 | $67.61 | $151.36 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $123.03 / $223.87
| Professional | | $67.61 | $123.03 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $7,413.10 / $7,413.10
| Facility | | $7,413.10 | $7,413.10 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $117.49 / $229.09
| Professional | | $54.95 | $117.49 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $7,413.10 / $7,413.10
| Facility | | $7,413.10 | $7,413.10 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $112.20 / $208.93
| Professional | | $57.54 | $112.20 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.18 / $69.18 / $112.20
| Facility | | $69.18 | $69.18 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $104.71 / $104.71 / $104.71
| Facility | 50 | $104.71 | $104.71 | $104.71 |