- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.25 / $2,507.00 / $11,050.00
| Facility | | $235.25 | $2,507.00 | $11,050.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,604.80 / $10,435.00 / $11,819.00
| Facility | 50 | $1,604.80 | $10,435.00 | $11,819.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.80 / $255.67 / $638.02
| Professional | | $156.80 | $255.67 | $638.02 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $351.72 / $957.03 / $1,382.01
| Professional | 50 | $351.72 | $957.03 | $1,382.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,224.00 / $4,449.00 / $10,043.00
| Facility | | $2,224.00 | $4,449.00 | $10,043.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.36 / $288.14 / $432.26
| Professional | | $181.36 | $288.14 | $432.26 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $272.04 / $432.22 / $648.39
| Professional | 50 | $272.04 | $432.22 | $648.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,533.00 / $13,106.00 / $17,811.00
| Facility | | $11,533.00 | $13,106.00 | $17,811.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.52 / $313.38 / $545.82
| Professional | | $169.52 | $313.38 | $545.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.66 / $381.43 / $2,831.00
| Facility | | $165.66 | $381.43 | $2,831.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.89 / $487.44 / $3,411.19
| Professional | | $292.89 | $487.44 | $3,411.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,216.00 / $2,332.00 / $3,074.00
| Facility | | $1,216.00 | $2,332.00 | $3,074.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.20 / $366.91 / $601.87
| Professional | | $260.20 | $366.91 | $601.87 |