- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.00 / $2,897.00 / $7,562.14
| Facility | | $1,070.00 | $2,897.00 | $7,562.14 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,756.50 / $14,599.35 / $14,599.35
| Facility | 50 | $1,756.50 | $14,599.35 | $14,599.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.36 / $1,213.57 / $1,954.11
| Professional | | $277.36 | $1,213.57 | $1,954.11 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $628.94 / $628.94 / $628.94
| Professional | 50 | $628.94 | $628.94 | $628.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.56 / $631.16 / $851.56
| Professional | | $156.56 | $631.16 | $851.56 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $473.37 / $473.37 / $473.37
| Professional | 50 | $473.37 | $473.37 | $473.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.20 / $314.52 / $518.16
| Facility | | $79.20 | $314.52 | $518.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.66 / $1,078.94 / $1,765.54
| Professional | | $321.66 | $1,078.94 | $1,765.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.64 / $555.64 / $555.64
| Facility | | $555.64 | $555.64 | $555.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.22 / $1,293.64 / $2,813.59
| Professional | | $336.22 | $1,293.64 | $2,813.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.86 / $1,628.43 / $3,495.82
| Facility | | $336.86 | $1,628.43 | $3,495.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,457.93 / $2,096.17 / $11,504.00
| Professional | | $1,457.93 | $2,096.17 | $11,504.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,878.00 / $4,571.00 / $7,217.00
| Facility | | $2,878.00 | $4,571.00 | $7,217.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,400.00 / $1,751.42 / $3,363.10
| Professional | | $1,400.00 | $1,751.42 | $3,363.10 |