- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.41 / $2,656.81 / $9,727.00
| Facility | | $179.41 | $2,656.81 | $9,727.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.47 / $941.23 / $1,505.97
| Professional | | $144.47 | $941.23 | $1,505.97 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $1,334.22 / $1,334.22 / $1,334.22
| Professional | 50 | $1,334.22 | $1,334.22 | $1,334.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,910.79 / $4,324.38 / $8,116.91
| Facility | | $1,910.79 | $4,324.38 | $8,116.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.32 / $899.88 / $1,506.68
| Professional | | $138.32 | $899.88 | $1,506.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $991.05 / $991.05 / $1,273.52
| Facility | | $991.05 | $991.05 | $1,273.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.19 / $758.82 / $1,877.68
| Professional | | $186.19 | $758.82 | $1,877.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.41 / $1,120.74 / $1,802.83
| Facility | | $179.41 | $1,120.74 | $1,802.83 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $397.27 / $2,013.06 / $2,704.25
| Facility | 50 | $397.27 | $2,013.06 | $2,704.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $653.21 / $876.84 / $1,036.14
| Professional | | $653.21 | $876.84 | $1,036.14 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $979.82 / $979.82 / $1,554.21
| Professional | 50 | $979.82 | $979.82 | $1,554.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $712.87 / $964.89 / $1,496.48
| Professional | | $712.87 | $964.89 | $1,496.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,607.00 / $8,667.00
| Facility | | $659.00 | $6,607.00 | $8,667.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $938.77 / $1,480.67 / $2,375.16
| Professional | | $938.77 | $1,480.67 | $2,375.16 |