- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,109.98 / $3,109.98 / $3,109.98
| Facility | 50 | $3,109.98 | $3,109.98 | $3,109.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.24 / $438.24 / $2,370.92
| Professional | | $438.24 | $438.24 | $2,370.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,551.47 / $4,813.14 / $9,035.51
| Facility | | $3,551.47 | $4,813.14 | $9,035.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $419.39 / $712.58 / $953.16
| Professional | | $419.39 | $712.58 | $953.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $871.15 / $1,082.59 / $1,342.97
| Professional | | $871.15 | $1,082.59 | $1,342.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.33 / $804.88 / $7,772.00
| Facility | | $443.33 | $804.88 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $33,874.00 / $33,874.00 / $33,874.00
| Facility | 50 | $33,874.00 | $33,874.00 | $33,874.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $584.54 / $996.37 / $3,482.16
| Professional | | $584.54 | $996.37 | $3,482.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $871.15 / $1,082.59 / $2,571.84
| Facility | | $871.15 | $1,082.59 | $2,571.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $648.66 / $996.37 / $1,303.16
| Professional | | $648.66 | $996.37 | $1,303.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $471.00 / $1,252.90
| Professional | | $5.00 | $471.00 | $1,252.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $584.54 / $982.53 / $1,160.68
| Professional | | $584.54 | $982.53 | $1,160.68 |