- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,454.71 / $3,090.30
| Facility | | $575.44 | $2,454.71 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $512.86 / $1,513.56 / $3,548.13
| Facility | 50 | $512.86 | $1,513.56 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $186.21 / $1,174.90
| Professional | | $56.23 | $186.21 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $81.28 / $186.21 / $457.09
| Professional | 50 | $81.28 | $186.21 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64,565.42 / $83,176.38 / $95,499.26
| Facility | | $64,565.42 | $83,176.38 | $95,499.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $100.00 / $380.19
| Professional | | $91.20 | $100.00 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $91.20 / $91.20
| Facility | | $91.20 | $91.20 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $100.00 / $338.84
| Professional | | $75.86 | $100.00 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $123.03 / $426.58
| Facility | | $100.00 | $123.03 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $123.03 / $426.58
| Professional | | $100.00 | $123.03 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $199.53 / $363.08
| Facility | | $56.23 | $199.53 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $117.49 / $501.19
| Professional | | $77.62 | $117.49 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $154.88 / $316.23
| Professional | | $89.13 | $154.88 | $316.23 |