- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.24 / $618.80 / $8,500.00
| Facility | | $550.24 | $618.80 | $8,500.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,743.85 / $5,292.03 / $5,843.32
| Facility | 50 | $2,743.85 | $5,292.03 | $5,843.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.94 / $555.61 / $750.35
| Professional | | $472.94 | $555.61 | $750.35 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $2,140.01 / $2,140.01 / $2,140.01
| Professional | 50 | $2,140.01 | $2,140.01 | $2,140.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,083.59 / $1,222.33 / $1,438.05
| Professional | | $1,083.59 | $1,222.33 | $1,438.05 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $1,590.39 / $1,833.51 / $2,157.08
| Professional | 50 | $1,590.39 | $1,833.51 | $2,157.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $930.62 / $1,374.71 / $1,946.24
| Professional | | $930.62 | $1,374.71 | $1,946.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.24 / $751.65 / $1,650.72
| Facility | | $550.24 | $751.65 | $1,650.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,265.06 / $3,265.06 / $3,498.53
| Facility | 50 | $3,265.06 | $3,265.06 | $3,498.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $629.40 / $1,135.21 / $4,664.16
| Professional | | $629.40 | $1,135.21 | $4,664.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $622.13 / $755.28 / $1,335.58
| Professional | | $622.13 | $755.28 | $1,335.58 |