- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.60 / $672.13 / $4,500.00
| Facility | | $246.60 | $672.13 | $4,500.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,306.88 / $1,306.88 / $1,306.88
| Facility | 50 | $1,306.88 | $1,306.88 | $1,306.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.40 / $190.96 / $564.82
| Professional | | $72.40 | $190.96 | $564.82 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $218.00 / $218.00 / $218.00
| Professional | 50 | $218.00 | $218.00 | $218.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $573.77 / $573.77 / $575.38
| Facility | | $573.77 | $573.77 | $575.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.23 / $186.82 / $390.28
| Professional | | $96.23 | $186.82 | $390.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.35 / $227.95 / $593.05
| Facility | | $83.35 | $227.95 | $593.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.09 / $360.79 / $437.32
| Professional | | $136.09 | $360.79 | $437.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $311.05 / $391.33
| Professional | | $32.34 | $311.05 | $391.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,595.57 / $2,281.73 / $2,842.02
| Facility | | $1,595.57 | $2,281.73 | $2,842.02 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,368.01 / $3,422.61 / $4,306.64
| Facility | 50 | $2,368.01 | $3,422.61 | $4,306.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.21 / $321.08 / $473.69
| Professional | | $156.21 | $321.08 | $473.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.00 / $2,620.00 / $4,441.00
| Facility | | $450.00 | $2,620.00 | $4,441.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $207.06 / $307.93 / $420.22
| Professional | | $207.06 | $307.93 | $420.22 |