- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,236.00 / $2,494.29 / $6,614.70
| Facility | | $1,236.00 | $2,494.29 | $6,614.70 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,392.00 / $2,472.00 / $2,472.00
| Facility | 50 | $2,392.00 | $2,472.00 | $2,472.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.09 / $658.03 / $2,677.00
| Professional | | $525.09 | $658.03 | $2,677.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $793.24 / $793.24 / $866.21
| Professional | | $793.24 | $793.24 | $866.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,671.00 / $4,589.00 / $6,006.00
| Facility | | $3,671.00 | $4,589.00 | $6,006.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.03 / $795.91 / $1,144.13
| Professional | | $660.03 | $795.91 | $1,144.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,618.26 / $1,618.26 / $1,618.26
| Facility | | $1,618.26 | $1,618.26 | $1,618.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.88 / $636.90 / $1,072.86
| Professional | | $374.88 | $636.90 | $1,072.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.82 / $742.39 / $2,092.55
| Professional | | $5.82 | $742.39 | $2,092.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,674.04 / $4,232.04 / $4,232.04
| Facility | | $1,674.04 | $4,232.04 | $4,232.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.96 / $634.59 / $2,511.06
| Professional | | $3.96 | $634.59 | $2,511.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,282.00 / $2,947.00 / $19,673.00
| Facility | | $1,282.00 | $2,947.00 | $19,673.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $515.10 / $737.69 / $1,162.64
| Professional | | $515.10 | $737.69 | $1,162.64 |