- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $8,709.64 / $16,595.87
| Facility | | $323.59 | $8,709.64 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,019.95 / $7,943.28 / $29,512.09
| Facility | 50 | $3,019.95 | $7,943.28 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $323.59 / $1,000.00
| Professional | | $257.04 | $323.59 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $275.42 / $457.09 / $2,570.40
| Professional | 50 | $275.42 | $457.09 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $181.97 / $501.19
| Professional | | $120.23 | $181.97 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $165.96 / $269.15 / $724.44
| Professional | 50 | $165.96 | $269.15 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $3,981.07 / $9,549.93
| Facility | | $1,318.26 | $3,981.07 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $398.11 / $776.25
| Professional | | $218.78 | $398.11 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $3,090.30 / $3,981.07
| Facility | | $575.44 | $3,090.30 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $407.38 / $602.56
| Professional | | $281.84 | $407.38 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $446.68 / $831.76
| Facility | | $275.42 | $446.68 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $11,220.18 / $17,378.01
| Facility | | $2,754.23 | $11,220.18 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $346.74 / $616.60
| Professional | | $251.19 | $346.74 | $616.60 |