- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.61 / $3,401.00 / $10,632.00
| Facility | | $224.61 | $3,401.00 | $10,632.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,741.65 / $4,689.47 / $10,668.78
| Facility | 50 | $1,741.65 | $4,689.47 | $10,668.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.02 / $224.56 / $400.45
| Professional | | $150.02 | $224.56 | $400.45 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $255.71 / $255.71 / $501.02
| Professional | 50 | $255.71 | $255.71 | $501.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $789.58 / $939.97
| Facility | | $323.00 | $789.58 | $939.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.47 / $275.93 / $508.42
| Professional | | $170.47 | $275.93 | $508.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,561.00 / $4,821.00 / $9,360.00
| Facility | | $2,561.00 | $4,821.00 | $9,360.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.90 / $185.25 / $325.83
| Professional | | $172.90 | $185.25 | $325.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.25 / $289.48 / $387.67
| Professional | | $199.25 | $289.48 | $387.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.00 / $3,611.00 / $8,105.00
| Facility | | $803.00 | $3,611.00 | $8,105.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $215.06 / $320.43 / $531.29
| Professional | | $215.06 | $320.43 | $531.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.43 / $197.37 / $197.37
| Professional | | $128.43 | $197.37 | $197.37 |