- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,924.00 / $2,747.00 / $5,039.00
| Facility | | $1,924.00 | $2,747.00 | $5,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.01 / $3,087.03 / $7,135.40
| Professional | | $205.01 | $3,087.03 | $7,135.40 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $14,137.50 / $14,137.50 / $14,137.50
| Professional | 50 | $14,137.50 | $14,137.50 | $14,137.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.59 / $4,402.00 / $11,952.66
| Facility | | $617.59 | $4,402.00 | $11,952.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.74 / $5,384.12 / $16,069.74
| Professional | | $284.74 | $5,384.12 | $16,069.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $292.83 / $380.69 / $746.74
| Facility | | $292.83 | $380.69 | $746.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.23 / $480.23 / $6,099.85
| Professional | | $480.23 | $480.23 | $6,099.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.40 / $1,152.93 / $10,310.86
| Professional | | $399.40 | $1,152.93 | $10,310.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.32 / $376.09 / $6,679.00
| Facility | | $214.32 | $376.09 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,464.95 / $4,408.55 / $7,828.21
| Professional | | $3,464.95 | $4,408.55 | $7,828.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.75 / $3,618.00 / $8,032.32
| Professional | | $320.75 | $3,618.00 | $8,032.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,735.56 / $5,268.00 / $9,401.00
| Facility | | $1,735.56 | $5,268.00 | $9,401.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,761.85 / $8,041.05 / $21,145.72
| Professional | | $4,761.85 | $8,041.05 | $21,145.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $6,104.00 / $20,029.34
| Facility | | $2,155.00 | $6,104.00 | $20,029.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,359.26 / $6,347.52 / $13,837.25
| Professional | | $4,359.26 | $6,347.52 | $13,837.25 |