- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.32 / $5,107.20 / $9,062.00
| Facility | | $601.32 | $5,107.20 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $11,745.88 / $11,745.88 / $11,745.88
| Facility | 50 | $11,745.88 | $11,745.88 | $11,745.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $448.50 / $601.32 / $896.02
| Professional | | $448.50 | $601.32 | $896.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,888.00 / $7,454.68 / $13,433.48
| Facility | | $1,888.00 | $7,454.68 | $13,433.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.00 / $536.24 / $864.46
| Professional | | $486.00 | $536.24 | $864.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $1,956.98 / $2,514.75
| Facility | | $375.00 | $1,956.98 | $2,514.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $481.24 / $664.33 / $1,417.10
| Professional | | $481.24 | $664.33 | $1,417.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $451.00 / $601.32 / $1,088.20
| Facility | | $451.00 | $601.32 | $1,088.20 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $676.50 / $879.23 / $1,471.67
| Facility | 50 | $676.50 | $879.23 | $1,471.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,512.64 / $1,731.45 / $1,899.29
| Professional | | $1,512.64 | $1,731.45 | $1,899.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.49 / $414.57 / $745.54
| Professional | | $75.49 | $414.57 | $745.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,114.00 / $13,190.00 / $19,665.00
| Facility | | $5,114.00 | $13,190.00 | $19,665.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $470.35 / $665.22 / $1,193.84
| Professional | | $470.35 | $665.22 | $1,193.84 |