- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $452.66 / $2,079.00 / $3,685.00
| Facility | | $452.66 | $2,079.00 | $3,685.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $958.46 / $1,986.00 / $3,003.77
| Facility | 50 | $958.46 | $1,986.00 | $3,003.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.13 / $418.63 / $823.43
| Professional | | $210.13 | $418.63 | $823.43 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $526.30 / $587.88 / $734.40
| Professional | 50 | $526.30 | $587.88 | $734.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.80 / $2,854.00 / $9,039.00
| Facility | | $446.80 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.12 / $636.99 / $1,823.06
| Professional | | $245.12 | $636.99 | $1,823.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.56 / $287.27 / $570.08
| Facility | | $223.56 | $287.27 | $570.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.31 / $401.25 / $1,242.75
| Professional | | $88.31 | $401.25 | $1,242.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.62 / $539.73 / $1,112.16
| Professional | | $267.62 | $539.73 | $1,112.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.54 / $407.64 / $6,679.00
| Facility | | $194.54 | $407.64 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.25 / $609.11 / $843.92
| Professional | | $499.25 | $609.11 | $843.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.97 / $543.11 / $1,268.71
| Professional | | $259.97 | $543.11 | $1,268.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.00 / $1,626.28 / $4,571.13
| Facility | | $933.00 | $1,626.28 | $4,571.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.77 / $693.82 / $1,102.86
| Professional | | $300.77 | $693.82 | $1,102.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,100.15 / $3,764.00 / $40,000.00
| Facility | | $1,100.15 | $3,764.00 | $40,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $517.09 / $929.24 / $3,108.48
| Professional | | $517.09 | $929.24 | $3,108.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.92 / $725.20 / $1,334.57
| Professional | | $473.92 | $725.20 | $1,334.57 |