- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $724.44 / $2,951.21
| Facility | | $151.36 | $724.44 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $616.60 / $1,621.81
| Professional | | $144.54 | $616.60 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $3,090.30 / $7,079.46
| Facility | | $1,479.11 | $3,090.30 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,630.78 / $6,606.93 / $16,595.87
| Facility | 50 | $3,630.78 | $6,606.93 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $776.25 / $2,041.74
| Professional | | $251.19 | $776.25 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $2,511.89 / $5,888.44
| Facility | | $1,778.28 | $2,511.89 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $199.53 / $199.53 / $199.53
| Facility | 52 | $199.53 | $199.53 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $1,000.00 / $2,754.23
| Professional | | $338.84 | $1,000.00 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,398.83 / $4,677.35
| Facility | | $1,905.46 | $2,398.83 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $977.24 / $2,570.40
| Professional | | $316.23 | $977.24 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $1,023.29 / $3,981.07
| Facility | | $194.98 | $1,023.29 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $1,412.54 / $3,548.13
| Professional | | $724.44 | $1,412.54 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,162.28 / $5,754.40
| Facility | | $1,584.89 | $3,162.28 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $676.08 / $2,137.96
| Professional | | $229.09 | $676.08 | $2,137.96 |