- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $2,041.74 / $8,317.64
| Facility | | $309.03 | $2,041.74 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,754.23 / $2,754.23 / $7,762.47
| Facility | 50 | $2,754.23 | $2,754.23 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $446.68 / $1,230.27
| Professional | | $234.42 | $446.68 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $645.65 / $660.69 / $3,801.89
| Professional | 50 | $645.65 | $660.69 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $2,570.40 / $2,951.21
| Facility | | $2,137.96 | $2,570.40 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $295.12 / $426.58
| Professional | | $204.17 | $295.12 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $309.03 / $446.68 / $630.96
| Professional | 50 | $309.03 | $446.68 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $707.95 / $2,511.89
| Professional | | $204.17 | $707.95 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $446.68 / $851.14
| Professional | | $208.93 | $446.68 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $275.42 / $354.81
| Professional | | $186.21 | $275.42 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $691.83 / $812.83
| Professional | | $588.84 | $691.83 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $478.63 / $851.14
| Facility | | $245.47 | $478.63 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $575.44 / $4,073.80
| Facility | | $251.19 | $575.44 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $616.60 / $4,073.80
| Professional | | $302.00 | $616.60 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,137.96 / $3,981.07
| Facility | | $1,071.52 | $2,137.96 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $489.78 / $912.01
| Professional | | $346.74 | $489.78 | $912.01 |