- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.48 / $1,943.87 / $6,659.00
| Facility | | $437.48 | $1,943.87 | $6,659.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.48 / $1,943.87 / $2,636.91
| Professional | | $437.48 | $1,943.87 | $2,636.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,199.79 / $27,584.05 / $62,316.23
| Facility | | $7,199.79 | $27,584.05 | $62,316.23 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $34,347.44 / $60,472.33 / $105,887.75
| Facility | 50 | $34,347.44 | $60,472.33 | $105,887.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $753.96 / $2,358.61 / $5,612.42
| Professional | | $753.96 | $2,358.61 | $5,612.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,224.80 / $5,991.29 / $14,412.85
| Facility | | $4,224.80 | $5,991.29 | $14,412.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $915.15 / $2,912.30 / $7,000.90
| Professional | | $915.15 | $2,912.30 | $7,000.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,326.61 / $5,467.44 / $11,348.70
| Facility | | $3,326.61 | $5,467.44 | $11,348.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $846.08 / $2,721.54 / $5,670.84
| Professional | | $846.08 | $2,721.54 | $5,670.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $695.54 / $3,307.40 / $11,890.00
| Facility | | $695.54 | $3,307.40 | $11,890.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,060.84 / $3,060.84 / $3,060.84
| Facility | 50 | $3,060.84 | $3,060.84 | $3,060.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,408.42 / $4,301.81 / $8,432.20
| Professional | | $2,408.42 | $4,301.81 | $8,432.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,733.00 / $8,467.00 / $12,774.00
| Facility | | $4,733.00 | $8,467.00 | $12,774.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,341.48 / $4,296.96 / $8,051.38
| Professional | | $2,341.48 | $4,296.96 | $8,051.38 |