- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $228.72 / $9,062.00 / $16,467.00
| Facility | | $228.72 | $9,062.00 | $16,467.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.90 / $418.66 / $545.87
| Professional | | $190.90 | $418.66 | $545.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $780.00 / $2,271.36 / $4,782.32
| Facility | | $780.00 | $2,271.36 | $4,782.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.07 / $473.77 / $707.50
| Professional | | $190.07 | $473.77 | $707.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,512.28 / $1,512.28 / $1,512.28
| Facility | | $1,512.28 | $1,512.28 | $1,512.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.84 / $512.27 / $931.21
| Professional | | $241.84 | $512.27 | $931.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $228.72 / $545.87 / $886.14
| Facility | | $228.72 | $545.87 | $886.14 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $518.79 / $989.01 / $1,342.24
| Facility | 50 | $518.79 | $989.01 | $1,342.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,300.71 / $1,300.71 / $1,300.71
| Professional | | $1,300.71 | $1,300.71 | $1,300.71 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $1,951.06 / $1,951.06 / $1,951.06
| Professional | 50 | $1,951.06 | $1,951.06 | $1,951.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.25 / $384.88 / $608.14
| Professional | | $32.25 | $384.88 | $608.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $10,257.00 / $16,249.00
| Facility | | $1,981.00 | $10,257.00 | $16,249.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.02 / $631.97 / $1,166.41
| Professional | | $321.02 | $631.97 | $1,166.41 |