- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $936.00 / $2,788.00 / $6,483.00
| Facility | | $936.00 | $2,788.00 | $6,483.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,251.00 / $1,251.00 / $1,251.00
| Facility | 50 | $1,251.00 | $1,251.00 | $1,251.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.03 / $246.82 / $832.86
| Professional | | $138.03 | $246.82 | $832.86 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $342.56 / $342.56 / $1,936.50
| Professional | 50 | $342.56 | $342.56 | $1,936.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.76 / $207.23 / $310.85
| Professional | | $66.76 | $207.23 | $310.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.79 / $2,211.19 / $3,616.69
| Facility | | $552.79 | $2,211.19 | $3,616.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.11 / $177.64 / $249.08
| Professional | | $142.11 | $177.64 | $249.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $150.00 / $150.00
| Facility | | $150.00 | $150.00 | $150.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.56 / $250.22 / $424.83
| Professional | | $136.56 | $250.22 | $424.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.97 / $313.45 / $3,159.00
| Facility | | $149.97 | $313.45 | $3,159.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.00 / $284.76 / $2,232.84
| Professional | | $231.00 | $284.76 | $2,232.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,223.00 / $2,376.00 / $4,640.00
| Facility | | $1,223.00 | $2,376.00 | $4,640.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.00 / $270.26 / $537.13
| Professional | | $231.00 | $270.26 | $537.13 |