- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.32 / $982.50 / $3,555.52
| Facility | | $57.32 | $982.50 | $3,555.52 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,273.32 / $2,273.32 / $3,369.16
| Facility | 50 | $2,273.32 | $2,273.32 | $3,369.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.79 / $177.66 / $952.85
| Professional | | $54.79 | $177.66 | $952.85 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $16.73 / $172.72 / $994.58
| Professional | 50 | $16.73 | $172.72 | $994.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $48.37 / $3,730.80
| Facility | | $0.98 | $48.37 | $3,730.80 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.02 / $1.50 / $1.50
| Facility | 50 | $0.02 | $1.50 | $1.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.95 / $352.00 / $819.29
| Professional | | $112.95 | $352.00 | $819.29 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $166.34 / $499.40 / $1,228.94
| Professional | 50 | $166.34 | $499.40 | $1,228.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.01 / $868.35 / $2,088.94
| Facility | | $612.01 | $868.35 | $2,088.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.18 / $354.77 / $975.46
| Professional | | $124.18 | $354.77 | $975.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $497.78 / $793.88 / $1,644.84
| Facility | | $497.78 | $793.88 | $1,644.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.95 / $354.77 / $822.77
| Professional | | $122.95 | $354.77 | $822.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.22 / $283.04 / $1,011.35
| Facility | | $79.22 | $283.04 | $1,011.35 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $489.00 / $1,718.28 / $2,113.02
| Facility | 50 | $489.00 | $1,718.28 | $2,113.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.99 / $349.52 / $894.79
| Professional | | $190.99 | $349.52 | $894.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.00 / $1,727.00 / $2,883.00
| Facility | | $382.00 | $1,727.00 | $2,883.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.09 / $329.90 / $663.23
| Professional | | $182.09 | $329.90 | $663.23 |