- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.31 / $4,241.22 / $13,841.56
| Facility | | $315.31 | $4,241.22 | $13,841.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.97 / $528.44 / $1,609.79
| Professional | | $280.97 | $528.44 | $1,609.79 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $1,055.08 / $1,055.08 / $1,164.56
| Professional | 50 | $1,055.08 | $1,055.08 | $1,164.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.77 / $394.60 / $770.45
| Professional | | $170.77 | $394.60 | $770.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,180.02 / $5,453.87 / $10,634.64
| Facility | | $4,180.02 | $5,453.87 | $10,634.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.13 / $493.27 / $661.66
| Professional | | $291.13 | $493.27 | $661.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $258.62 / $258.62 / $258.62
| Facility | | $258.62 | $258.62 | $258.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $635.45 / $774.27 / $969.98
| Professional | | $635.45 | $774.27 | $969.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.31 / $599.09 / $2,470.44
| Facility | | $315.31 | $599.09 | $2,470.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.53 / $795.63 / $2,770.04
| Professional | | $486.53 | $795.63 | $2,770.04 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $1,065.08 / $1,065.08 / $1,065.08
| Professional | 50 | $1,065.08 | $1,065.08 | $1,065.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $290.14 / $655.02 / $1,001.67
| Facility | | $290.14 | $655.02 | $1,001.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $589.13 / $793.63 / $1,790.03
| Professional | | $589.13 | $793.63 | $1,790.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.00 / $3,227.00 / $6,169.00
| Facility | | $1,775.00 | $3,227.00 | $6,169.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $516.04 / $755.87 / $1,576.10
| Professional | | $516.04 | $755.87 | $1,576.10 |