- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.93 / $2,497.00 / $4,410.00
| Facility | | $217.93 | $2,497.00 | $4,410.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.84 / $1,652.80 / $2,197.63
| Facility | 50 | $0.84 | $1,652.80 | $2,197.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.75 / $157.49 / $456.16
| Professional | | $129.75 | $157.49 | $456.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $381.26 / $3,592.00 / $10,821.00
| Facility | | $381.26 | $3,592.00 | $10,821.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.85 / $288.66 / $1,102.80
| Professional | | $147.85 | $288.66 | $1,102.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.22 / $299.22 / $299.22
| Professional | | $299.22 | $299.22 | $299.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.78 / $321.68 / $590.30
| Professional | | $197.78 | $321.68 | $590.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $155.91 / $332.68 / $6,679.00
| Facility | | $155.91 | $332.68 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.40 / $221.63 / $396.26
| Professional | | $175.40 | $221.63 | $396.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.01 / $374.97 / $499.73
| Professional | | $188.01 | $374.97 | $499.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,449.12 / $1,449.12 / $4,115.38
| Facility | | $1,449.12 | $1,449.12 | $4,115.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.31 / $244.31 / $673.78
| Professional | | $244.31 | $244.31 | $673.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $822.00 / $3,672.00 / $26,542.00
| Facility | | $822.00 | $3,672.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.14 / $326.86 / $1,102.80
| Professional | | $171.14 | $326.86 | $1,102.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,672.00 / $9,383.43
| Facility | | $1,640.00 | $3,672.00 | $9,383.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.16 / $262.63 / $520.33
| Professional | | $169.16 | $262.63 | $520.33 |