- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $2,648.75 / $6,435.00
| Facility | | $500.00 | $2,648.75 | $6,435.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $979.34 / $3,217.50 / $6,087.00
| Facility | 50 | $979.34 | $3,217.50 | $6,087.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.00 / $337.51 / $468.29
| Professional | | $171.00 | $337.51 | $468.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,832.80 / $2,927.28 / $4,626.02
| Facility | | $1,832.80 | $2,927.28 | $4,626.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.71 / $401.45 / $551.25
| Professional | | $221.71 | $401.45 | $551.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,491.09 / $1,491.09 / $1,491.09
| Facility | | $1,491.09 | $1,491.09 | $1,491.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.51 / $374.65 / $648.32
| Professional | | $237.51 | $374.65 | $648.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.56 / $425.51 / $4,232.60
| Facility | | $179.56 | $425.51 | $4,232.60 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,817.50 / $3,817.50 / $3,817.50
| Facility | 50 | $3,817.50 | $3,817.50 | $3,817.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.27 / $505.02 / $1,646.13
| Professional | | $366.27 | $505.02 | $1,646.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.00 / $3,317.00 / $5,543.93
| Facility | | $884.00 | $3,317.00 | $5,543.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.73 / $460.28 / $651.21
| Professional | | $344.73 | $460.28 | $651.21 |