- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.51 / $2,507.00 / $6,962.00
| Facility | | $188.51 | $2,507.00 | $6,962.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $877.20 / $3,826.00 / $6,808.19
| Facility | 50 | $877.20 | $3,826.00 | $6,808.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.41 / $154.09 / $552.02
| Professional | | $139.41 | $154.09 | $552.02 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $174.76 / $425.70 / $1,808.91
| Professional | 50 | $174.76 | $425.70 | $1,808.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,234.00 / $4,257.00 / $9,640.00
| Facility | | $2,234.00 | $4,257.00 | $9,640.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.38 / $215.46 / $304.56
| Professional | | $159.38 | $215.46 | $304.56 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $239.08 / $319.81 / $456.84
| Professional | 50 | $239.08 | $319.81 | $456.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,652.00 / $5,249.00 / $6,727.00
| Facility | | $2,652.00 | $5,249.00 | $6,727.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.00 / $239.70 / $404.27
| Professional | | $157.00 | $239.70 | $404.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.55 / $333.13 / $5,100.00
| Facility | | $141.55 | $333.13 | $5,100.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $628.98 / $1,639.18 / $3,115.00
| Facility | 50 | $628.98 | $1,639.18 | $3,115.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.49 / $266.18 / $1,429.86
| Professional | | $162.49 | $266.18 | $1,429.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,216.00 / $2,332.00 / $3,071.00
| Facility | | $1,216.00 | $2,332.00 | $3,071.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.68 / $194.02 / $335.72
| Professional | | $161.68 | $194.02 | $335.72 |