- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.58 / $2,083.00 / $3,685.00
| Facility | | $174.58 | $2,083.00 | $3,685.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,764.81 / $2,764.81 / $2,764.81
| Facility | 50 | $2,764.81 | $2,764.81 | $2,764.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.92 / $171.74 / $307.27
| Professional | | $98.92 | $171.74 | $307.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.35 / $1,339.09 / $4,393.72
| Facility | | $212.35 | $1,339.09 | $4,393.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.69 / $242.31 / $696.00
| Professional | | $104.69 | $242.31 | $696.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.75 / $146.58 / $277.48
| Facility | | $112.75 | $146.58 | $277.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.00 / $270.83 / $467.99
| Professional | | $168.00 | $270.83 | $467.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.30 / $161.30 / $161.30
| Facility | | $161.30 | $161.30 | $161.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.18 / $244.48 / $483.40
| Professional | | $119.18 | $244.48 | $483.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.10 / $205.58 / $6,679.00
| Facility | | $97.10 | $205.58 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.59 / $249.07 / $345.14
| Professional | | $196.59 | $249.07 | $345.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.15 / $258.55 / $564.50
| Professional | | $117.15 | $258.55 | $564.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,963.01 / $5,963.01 / $5,963.01
| Facility | | $5,963.01 | $5,963.01 | $5,963.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $230.90 / $230.90 / $276.10
| Professional | | $230.90 | $230.90 | $276.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,600.00 / $7,161.00
| Facility | | $55.00 | $1,600.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.74 / $331.83 / $2,086.50
| Professional | | $191.74 | $331.83 | $2,086.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $2,430.00 / $6,750.13
| Facility | | $789.00 | $2,430.00 | $6,750.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.77 / $260.69 / $608.14
| Professional | | $172.77 | $260.69 | $608.14 |