- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.50 / $1,802.68 / $6,970.72
| Facility | | $229.50 | $1,802.68 | $6,970.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,357.41 / $2,930.00 / $5,493.00
| Facility | 50 | $1,357.41 | $2,930.00 | $5,493.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.83 / $365.97 / $999.76
| Professional | | $186.83 | $365.97 | $999.76 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $293.02 / $540.41 / $1,974.32
| Professional | 50 | $293.02 | $540.41 | $1,974.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.49 / $228.49 / $246.96
| Professional | | $228.49 | $228.49 | $246.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $342.73 / $418.78 / $723.08
| Professional | 50 | $342.73 | $418.78 | $723.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $821.00 / $1,963.00 / $4,852.00
| Facility | | $821.00 | $1,963.00 | $4,852.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $250.55 / $402.76
| Professional | | $199.53 | $250.55 | $402.76 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $299.30 / $375.82 / $604.14
| Professional | 50 | $299.30 | $375.82 | $604.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.37 / $432.93 / $766.89
| Professional | | $225.37 | $432.93 | $766.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.76 / $461.12 / $3,018.00
| Facility | | $189.76 | $461.12 | $3,018.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,628.50 / $4,578.00 / $5,660.50
| Facility | 50 | $3,628.50 | $4,578.00 | $5,660.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.22 / $725.13 / $3,287.44
| Professional | | $426.22 | $725.13 | $3,287.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,410.06 / $2,833.00 / $5,813.00
| Facility | | $1,410.06 | $2,833.00 | $5,813.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.16 / $615.55 / $921.53
| Professional | | $393.16 | $615.55 | $921.53 |