- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,150.00 / $3,779.00 / $12,600.00
| Facility | | $1,150.00 | $3,779.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,250.00 / $4,348.00 / $39,461.69
| Facility | 50 | $2,250.00 | $4,348.00 | $39,461.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.47 / $1,477.14 / $2,359.67
| Professional | | $343.47 | $1,477.14 | $2,359.67 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $299.81 / $299.81 / $299.81
| Professional | 50 | $299.81 | $299.81 | $299.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,646.01 / $4,944.21 / $7,161.81
| Facility | | $3,646.01 | $4,944.21 | $7,161.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.30 / $1,031.82 / $2,598.12
| Professional | | $342.30 | $1,031.82 | $2,598.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $519.12 / $519.12 / $519.12
| Facility | | $519.12 | $519.12 | $519.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $386.44 / $566.29 / $2,880.76
| Professional | | $386.44 | $566.29 | $2,880.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.87 / $2,359.78 / $8,072.00
| Facility | | $454.87 | $2,359.78 | $8,072.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,737.96 / $2,406.28 / $14,571.52
| Professional | | $1,737.96 | $2,406.28 | $14,571.52 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $466.37 / $466.37 / $466.37
| Professional | 50 | $466.37 | $466.37 | $466.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $6,980.00 / $13,541.98
| Facility | | $1,851.00 | $6,980.00 | $13,541.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,708.97 / $2,129.58 / $3,511.63
| Professional | | $1,708.97 | $2,129.58 | $3,511.63 |