- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.88 / $330.88 / $6,781.00
| Facility | | $330.88 | $330.88 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $9,303.00 / $13,994.39 / $13,994.39
| Facility | 50 | $9,303.00 | $13,994.39 | $13,994.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.88 / $367.08 / $472.82
| Professional | | $330.88 | $367.08 | $472.82 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $546.99 / $2,264.21 / $2,723.37
| Professional | 50 | $546.99 | $2,264.21 | $2,723.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,520.79 / $10,766.58 / $24,323.22
| Facility | | $1,520.79 | $10,766.58 | $24,323.22 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $15,606.43 / $23,678.36 / $41,517.91
| Facility | 50 | $15,606.43 | $23,678.36 | $41,517.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.63 / $835.31 / $1,172.65
| Professional | | $537.63 | $835.31 | $1,172.65 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $783.15 / $1,210.83 / $1,694.55
| Professional | 50 | $783.15 | $1,210.83 | $1,694.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.99 / $1,090.52 / $2,623.39
| Facility | | $768.99 | $1,090.52 | $2,623.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $623.38 / $1,051.40 / $1,495.57
| Professional | | $623.38 | $1,051.40 | $1,495.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.13 / $997.00 / $2,065.66
| Facility | | $625.13 | $997.00 | $2,065.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $548.82 / $939.20 / $1,244.64
| Professional | | $548.82 | $939.20 | $1,244.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $536.29 / $637.26 / $9,233.00
| Facility | | $536.29 | $637.26 | $9,233.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,933.96 / $4,258.50 / $7,493.61
| Facility | 50 | $1,933.96 | $4,258.50 | $7,493.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $506.39 / $831.17 / $1,787.31
| Professional | | $506.39 | $831.17 | $1,787.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,991.00 / $9,787.00 / $22,901.76
| Facility | | $3,991.00 | $9,787.00 | $22,901.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $428.48 / $831.17 / $1,342.18
| Professional | | $428.48 | $831.17 | $1,342.18 |