- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.34 / $531.34 / $3,119.00
| Facility | | $531.34 | $531.34 | $3,119.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,809.48 / $5,809.48 / $5,809.48
| Facility | 50 | $5,809.48 | $5,809.48 | $5,809.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $493.35 / $531.34 / $831.51
| Professional | | $493.35 | $531.34 | $831.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,287.48 / $6,592.74 / $13,546.10
| Facility | | $2,287.48 | $6,592.74 | $13,546.10 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,691.53 / $13,186.96 / $23,122.16
| Facility | 50 | $8,691.53 | $13,186.96 | $23,122.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $940.70 / $1,450.18 / $2,034.78
| Professional | | $940.70 | $1,450.18 | $2,034.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,340.88 / $1,901.54 / $4,574.41
| Facility | | $1,340.88 | $1,901.54 | $4,574.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,095.16 / $1,838.63 / $2,627.43
| Professional | | $1,095.16 | $1,838.63 | $2,627.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,090.04 / $1,738.46 / $3,601.90
| Facility | | $1,090.04 | $1,738.46 | $3,601.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $964.18 / $1,650.01 / $2,186.61
| Professional | | $964.18 | $1,650.01 | $2,186.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $603.86 / $1,042.02 / $9,232.98
| Facility | | $603.86 | $1,042.02 | $9,232.98 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,991.12 / $4,991.12 / $8,577.00
| Facility | 50 | $4,991.12 | $4,991.12 | $8,577.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $661.38 / $1,293.76 / $2,010.17
| Professional | | $661.38 | $1,293.76 | $2,010.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,991.00 / $9,404.00 / $12,668.51
| Facility | | $3,991.00 | $9,404.00 | $12,668.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $682.04 / $1,382.81 / $1,994.81
| Professional | | $682.04 | $1,382.81 | $1,994.81 |