- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.42 / $2,133.00 / $7,045.00
| Facility | | $177.42 | $2,133.00 | $7,045.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,443.25 / $2,443.25 / $2,443.25
| Facility | 50 | $2,443.25 | $2,443.25 | $2,443.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.84 / $162.91 / $304.57
| Professional | | $93.84 | $162.91 | $304.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,449.90 / $3,931.00 / $8,240.00
| Facility | | $1,449.90 | $3,931.00 | $8,240.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.61 / $131.43 / $236.36
| Professional | | $92.61 | $131.43 | $236.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.30 / $164.73 / $591.00
| Facility | | $161.30 | $164.73 | $591.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.64 / $173.21 / $343.54
| Professional | | $97.64 | $173.21 | $343.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $745.00 / $2,300.00 / $4,604.74
| Facility | | $745.00 | $2,300.00 | $4,604.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.33 / $200.52 / $345.32
| Professional | | $139.33 | $200.52 | $345.32 |