- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,521.00 / $7,960.15
| Facility | | $1,671.00 | $4,521.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,325.69 / $5,377.50 / $8,112.00
| Facility | 50 | $2,325.69 | $5,377.50 | $8,112.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.87 / $367.08 / $821.27
| Professional | | $340.87 | $367.08 | $821.27 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $546.99 / $1,125.00 / $2,795.80
| Professional | 50 | $546.99 | $1,125.00 | $2,795.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $944.35 / $3,555.20 / $5,814.97
| Facility | | $944.35 | $3,555.20 | $5,814.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.89 / $263.86 / $329.82
| Professional | | $197.89 | $263.86 | $329.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,469.03 / $4,469.03 / $4,469.03
| Facility | | $4,469.03 | $4,469.03 | $4,469.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.14 / $423.91 / $709.57
| Professional | | $318.14 | $423.91 | $709.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.71 / $522.05 / $6,117.00
| Facility | | $336.71 | $522.05 | $6,117.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,810.04 / $2,810.04 / $2,810.04
| Facility | 50 | $2,810.04 | $2,810.04 | $2,810.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.00 / $430.50 / $6,125.60
| Professional | | $328.00 | $430.50 | $6,125.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,021.00 / $4,545.00 / $7,217.00
| Facility | | $3,021.00 | $4,545.00 | $7,217.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.23 / $402.60 / $735.82
| Professional | | $307.23 | $402.60 | $735.82 |