- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.80 / $1,473.20 / $3,363.00
| Facility | | $204.80 | $1,473.20 | $3,363.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,407.26 / $1,407.26 / $2,648.00
| Facility | 50 | $1,407.26 | $1,407.26 | $2,648.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.44 / $191.53 / $445.34
| Professional | | $64.44 | $191.53 | $445.34 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $154.57 / $175.40 / $340.36
| Professional | 50 | $154.57 | $175.40 | $340.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.92 / $627.00 / $2,733.00
| Facility | | $73.92 | $627.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.73 / $322.82 / $928.79
| Professional | | $74.73 | $322.82 | $928.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.28 / $98.02 / $194.90
| Facility | | $76.28 | $98.02 | $194.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.33 / $125.48 / $639.96
| Professional | | $24.33 | $125.48 | $639.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.44 / $230.06 / $629.54
| Professional | | $89.44 | $230.06 | $629.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.12 / $168.26 / $6,679.00
| Facility | | $78.12 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.35 / $354.24 / $494.47
| Professional | | $290.35 | $354.24 | $494.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.13 / $271.30 / $676.82
| Professional | | $88.13 | $271.30 | $676.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.50 / $868.43 / $2,019.60
| Facility | | $466.50 | $868.43 | $2,019.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.28 / $224.00 / $1,140.00
| Professional | | $104.28 | $224.00 | $1,140.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.26 / $428.39 / $2,060.00
| Professional | | $231.26 | $428.39 | $2,060.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.35 / $365.23 / $744.19
| Professional | | $221.35 | $365.23 | $744.19 |