- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $3,981.07 / $10,000.00
| Facility | | $660.69 | $3,981.07 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.25 / $0.25 / $23,442.29
| Facility | 50 | $0.25 | $0.25 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $562.34 / $1,047.13
| Professional | | $407.38 | $562.34 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $416.87 / $676.08 / $1,905.46
| Professional | 50 | $416.87 | $676.08 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $1,023.29 / $1,230.27
| Facility | | $446.68 | $1,023.29 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $588.84 / $1,122.02
| Professional | | $363.08 | $588.84 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $5,888.44 / $11,481.54
| Facility | | $3,235.94 | $5,888.44 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $436.52 / $660.69
| Professional | | $257.04 | $436.52 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $660.69
| Professional | | $32.36 | $33.11 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,623.41 / $9,772.37
| Facility | | $1,698.24 | $5,623.41 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $501.19 / $870.96
| Professional | | $354.81 | $501.19 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $446.68 / $588.84
| Professional | | $354.81 | $446.68 | $588.84 |