- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.08 / $5,678.00 / $11,059.55
| Facility | | $505.08 | $5,678.00 | $11,059.55 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,156.40 / $8,156.40 / $8,299.33
| Facility | 50 | $8,156.40 | $8,156.40 | $8,299.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.57 / $903.45 / $2,396.14
| Professional | | $294.57 | $903.45 | $2,396.14 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $156.31 / $785.60 / $2,710.34
| Professional | 50 | $156.31 | $785.60 | $2,710.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.91 / $841.31 / $3,603.72
| Professional | | $445.91 | $841.31 | $3,603.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,325.85 / $1,650.95 / $2,152.06
| Professional | | $1,325.85 | $1,650.95 | $2,152.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,888.83 / $10,419.48 / $15,184.17
| Facility | | $7,888.83 | $10,419.48 | $15,184.17 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $11,833.25 / $15,629.22 / $22,776.26
| Facility | 50 | $11,833.25 | $15,629.22 | $22,776.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $510.05 / $1,019.51 / $3,775.54
| Professional | | $510.05 | $1,019.51 | $3,775.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $9,753.00 / $15,824.00
| Facility | | $3,028.00 | $9,753.00 | $15,824.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,729.21 / $2,277.01 / $3,342.60
| Professional | | $1,729.21 | $2,277.01 | $3,342.60 |