- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $4,786.30 / $11,481.54
| Facility | | $1,000.00 | $4,786.30 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $954.99 / $2,344.23 / $16,982.44
| Facility | 50 | $954.99 | $2,344.23 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $2,818.38 / $5,370.32
| Professional | | $245.47 | $2,818.38 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $5,128.61 / $6,456.54 / $14,791.08
| Professional | 50 | $5,128.61 | $6,456.54 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $7,079.46 / $18,620.87
| Facility | | $3,467.37 | $7,079.46 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $3,019.95 / $7,585.78
| Professional | | $257.04 | $3,019.95 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $380.19 / $4,466.84 / $9,332.54
| Professional | 50 | $380.19 | $4,466.84 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- AS
- Low / Median / High Price
- $35.48 / $416.87 / $870.96
| Professional | AS | $35.48 | $416.87 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $7,413.10 / $23,442.29
| Facility | | $288.40 | $7,413.10 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $2,511.89 / $8,317.64
| Professional | | $288.40 | $2,511.89 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $5,754.40 / $14,125.38
| Facility | | $1,949.84 | $5,754.40 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $2,570.40 / $6,760.83
| Professional | | $251.19 | $2,570.40 | $6,760.83 |