- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $824.25 / $3,626.00 / $7,562.14
| Facility | | $824.25 | $3,626.00 | $7,562.14 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,499.00 / $1,735.00 / $5,366.00
| Facility | 50 | $1,499.00 | $1,735.00 | $5,366.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.99 / $723.30 / $3,517.00
| Professional | | $588.99 | $723.30 | $3,517.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $288.10 / $4,348.17 / $5,904.90
| Professional | 50 | $288.10 | $4,348.17 | $5,904.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.62 / $323.62 / $323.62
| Professional | | $323.62 | $323.62 | $323.62 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $922.32 / $922.32 / $922.32
| Professional | 50 | $922.32 | $922.32 | $922.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.45 / $3,106.86 / $5,113.62
| Facility | | $830.45 | $3,106.86 | $5,113.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $515.78 / $628.98 / $782.73
| Professional | | $515.78 | $628.98 | $782.73 |
- 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
- $672.15 / $911.10 / $1,531.85
| Professional | | $672.15 | $911.10 | $1,531.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $647.89 / $877.60 / $3,627.00
| Facility | | $647.89 | $877.60 | $3,627.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,753.79 / $2,753.79 / $2,753.79
| Facility | 50 | $2,753.79 | $2,753.79 | $2,753.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $750.72 / $1,069.04 / $6,141.92
| Professional | | $750.72 | $1,069.04 | $6,141.92 |
- 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
- $738.41 / $866.94 / $1,595.42
| Professional | | $738.41 | $866.94 | $1,595.42 |