- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $3,090.30 / $7,943.28
| Facility | | $436.52 | $3,090.30 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $588.84 / $3,467.37 / $7,943.28
| Facility | 50 | $588.84 | $3,467.37 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $169.82 / $457.09
| Professional | | $109.65 | $169.82 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $120.23 / $338.84 / $707.95
| Professional | 50 | $120.23 | $338.84 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $229.09 / $309.03
| Professional | | $131.83 | $229.09 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $199.53 / $338.84 / $457.09
| Professional | 50 | $199.53 | $338.84 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $208.93 / $363.08
| Professional | | $194.98 | $208.93 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $218.78 / $323.59
| Professional | | $177.83 | $218.78 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $3,090.30 / $7,943.28
| Facility | | $436.52 | $3,090.30 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.91 / $3,388.44 / $7,943.28
| Facility | 50 | $0.91 | $3,388.44 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $186.21 / $446.68
| Professional | | $138.04 | $186.21 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $120.23 / $338.84 / $707.95
| Professional | 50 | $120.23 | $338.84 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $229.09 / $354.81
| Professional | | $165.96 | $229.09 | $354.81 |