- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $984.00 / $4,067.38 / $7,605.00
| Facility | | $984.00 | $4,067.38 | $7,605.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,952.00 / $4,094.00 / $7,234.50
| Facility | 50 | $2,952.00 | $4,094.00 | $7,234.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $551.48 / $682.10 / $2,611.00
| Professional | | $551.48 | $682.10 | $2,611.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $409.14 / $805.68 / $1,088.93
| Professional | | $409.14 | $805.68 | $1,088.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.17 / $2,515.38 / $4,140.09
| Facility | | $688.17 | $2,515.38 | $4,140.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.28 / $543.04 / $678.80
| Professional | | $407.28 | $543.04 | $678.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,833.49 / $2,833.49 / $2,833.49
| Facility | | $2,833.49 | $2,833.49 | $2,833.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.99 / $733.87 / $1,416.36
| Professional | | $512.99 | $733.87 | $1,416.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $607.16 / $853.46 / $3,801.00
| Facility | | $607.16 | $853.46 | $3,801.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $164.32 / $826.90 / $826.90
| Facility | AS | $164.32 | $826.90 | $826.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $544.79 / $724.28 / $4,805.92
| Professional | | $544.79 | $724.28 | $4,805.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,343.00 / $3,339.00 / $5,838.00
| Facility | | $2,343.00 | $3,339.00 | $5,838.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $532.70 / $686.16 / $1,265.47
| Professional | | $532.70 | $686.16 | $1,265.47 |