- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.84 / $3,133.00 / $10,651.00
| Facility | | $246.84 | $3,133.00 | $10,651.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,730.91 / $7,720.50 / $7,845.00
| Facility | 50 | $6,730.91 | $7,720.50 | $7,845.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.69 / $190.21 / $359.33
| Professional | | $117.69 | $190.21 | $359.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $86.22 / $86.22 / $355.28
| Professional | 50 | $86.22 | $86.22 | $355.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,974.00 / $2,971.00 / $7,022.00
| Facility | | $1,974.00 | $2,971.00 | $7,022.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.57 / $167.97 / $273.77
| Professional | | $132.57 | $167.97 | $273.77 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $152.69 / $200.68 / $321.35
| Professional | 50 | $152.69 | $200.68 | $321.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.69 / $243.69 / $767.65
| Facility | | $243.69 | $243.69 | $767.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.29 / $233.72 / $417.50
| Professional | | $144.29 | $233.72 | $417.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.77 / $246.84 / $371.45
| Facility | | $130.77 | $246.84 | $371.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.54 / $261.81 / $443.69
| Professional | | $154.54 | $261.81 | $443.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,361.00 / $2,537.00 / $3,681.00
| Facility | | $1,361.00 | $2,537.00 | $3,681.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.72 / $319.68 / $580.10
| Professional | | $206.72 | $319.68 | $580.10 |