- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $977.24 / $3,235.94
| Facility | | $64.57 | $977.24 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $194.98 / $691.83
| Professional | | $63.10 | $194.98 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $97.72 / $213.80 / $575.44
| Professional | 50 | $97.72 | $213.80 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $2,041.74 / $7,079.46
| Facility | | $1.00 | $2,041.74 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.02 / $0.02 / $0.02
| Facility | 50 | $0.02 | $0.02 | $0.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $316.23 / $794.33
| Professional | | $120.23 | $316.23 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $173.78 / $457.09 / $1,148.15
| Professional | 50 | $173.78 | $457.09 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $977.24 / $2,344.23
| Facility | | $691.83 | $977.24 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $407.38 / $1,071.52
| Professional | | $144.54 | $407.38 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $933.25 / $1,819.70
| Facility | | $758.58 | $933.25 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $426.58 / $954.99
| Professional | | $144.54 | $426.58 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.18 / $302.00 / $1,445.44
| Facility | | $69.18 | $302.00 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $1,862.09
| Facility | 50 | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $380.19 / $954.99
| Professional | | $190.55 | $380.19 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,862.09 / $3,467.37
| Facility | | $380.19 | $1,862.09 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $213.80 / $630.96
| Professional | | $87.10 | $213.80 | $630.96 |