- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.51 / $7,119.04 / $19,276.96
| Facility | | $212.51 | $7,119.04 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,119.68 / $1,119.68 / $1,119.68
| Facility | 50 | $1,119.68 | $1,119.68 | $1,119.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.96 / $395.01 / $688.34
| Professional | | $122.96 | $395.01 | $688.34 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $649.23 / $686.42 / $1,342.50
| Professional | 50 | $649.23 | $686.42 | $1,342.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $528.12 / $715.74 / $1,343.62
| Facility | | $528.12 | $715.74 | $1,343.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.28 / $247.15 / $382.91
| Professional | | $130.28 | $247.15 | $382.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.08 / $439.58 / $584.33
| Professional | | $292.08 | $439.58 | $584.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.77 / $283.29 / $848.38
| Facility | | $156.77 | $283.29 | $848.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $114.24 / $114.24 / $689.28
| Facility | 50 | $114.24 | $114.24 | $689.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.08 / $452.58 / $1,506.00
| Professional | | $249.08 | $452.58 | $1,506.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.61 / $377.21 / $548.86
| Facility | | $234.61 | $377.21 | $548.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.87 / $394.11 / $540.05
| Professional | | $262.87 | $394.11 | $540.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $192.00 / $541.40
| Professional | | $4.00 | $192.00 | $541.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $273.17 / $430.07 / $516.60
| Professional | | $273.17 | $430.07 | $516.60 |