- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $509.76 / $2,292.00 / $4,276.43
| Facility | | $509.76 | $2,292.00 | $4,276.43 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,317.07 / $7,317.07 / $7,317.07
| Facility | 50 | $7,317.07 | $7,317.07 | $7,317.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.68 / $509.76 / $3,172.00
| Professional | | $145.68 | $509.76 | $3,172.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $744.91 / $2,656.15 / $5,761.70
| Facility | | $744.91 | $2,656.15 | $5,761.70 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,696.87 / $5,608.96 / $9,834.81
| Facility | 50 | $3,696.87 | $5,608.96 | $9,834.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $273.16 / $715.42 / $1,684.10
| Professional | | $273.16 | $715.42 | $1,684.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,250.76 / $1,773.74 / $4,266.96
| Facility | | $1,250.76 | $1,773.74 | $4,266.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.88 / $749.84 / $2,081.85
| Professional | | $358.88 | $749.84 | $2,081.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,016.78 / $1,621.62 / $3,359.81
| Facility | | $1,016.78 | $1,621.62 | $3,359.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.45 / $729.87 / $1,808.75
| Professional | | $316.45 | $729.87 | $1,808.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.30 / $1,662.00 / $3,224.84
| Facility | | $281.30 | $1,662.00 | $3,224.84 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,825.85 / $2,825.85 / $6,051.00
| Facility | 50 | $2,825.85 | $2,825.85 | $6,051.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $949.41 / $1,713.60 / $2,483.14
| Professional | | $949.41 | $1,713.60 | $2,483.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,296.00 / $3,500.00 / $6,361.00
| Facility | | $2,296.00 | $3,500.00 | $6,361.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $889.98 / $1,606.82 / $2,390.50
| Professional | | $889.98 | $1,606.82 | $2,390.50 |