- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,405.50 / $6,343.00 / $8,808.31
| Facility | | $2,405.50 | $6,343.00 | $8,808.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,089.11 / $5,163.50 / $10,721.29
| Facility | 50 | $1,089.11 | $5,163.50 | $10,721.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.39 / $408.50 / $701.99
| Professional | | $291.39 | $408.50 | $701.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,826.00 / $4,945.58 / $12,905.00
| Facility | | $2,826.00 | $4,945.58 | $12,905.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.72 / $595.67 / $748.19
| Professional | | $270.72 | $595.67 | $748.19 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $396.85 / $893.52 / $1,122.28
| Professional | 50 | $396.85 | $893.52 | $1,122.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.73 / $546.32 / $730.29
| Professional | | $343.73 | $546.32 | $730.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $434.90 / $437.39 / $437.39
| Professional | | $434.90 | $437.39 | $437.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.66 / $618.36 / $3,595.23
| Facility | | $31.66 | $618.36 | $3,595.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.52 / $299.52 / $449.27
| Professional | | $299.52 | $299.52 | $449.27 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $434.22 / $434.22 / $434.22
| Professional | 50 | $434.22 | $434.22 | $434.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,565.00 / $7,010.00 / $11,152.00
| Facility | | $4,565.00 | $7,010.00 | $11,152.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.64 / $460.68 / $733.67
| Professional | | $274.64 | $460.68 | $733.67 |