- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $3,890.45 / $10,232.93
| Facility | | $524.81 | $3,890.45 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,884.03 / $7,079.46 / $15,135.61
| Facility | 50 | $2,884.03 | $7,079.46 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $524.81 / $1,288.25
| Professional | | $302.00 | $524.81 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $245.47 / $1,862.09 / $2,570.40
| Professional | 50 | $245.47 | $1,862.09 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $338.84 / $380.19 / $380.19
| Professional | 52 | $338.84 | $380.19 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $7,413.10 / $15,135.61
| Facility | | $2,884.03 | $7,413.10 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $575.44 / $1,202.26
| Professional | | $354.81 | $575.44 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $537.03 / $851.14 / $1,698.24
| Professional | 50 | $537.03 | $851.14 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $1,258.93 / $3,630.78
| Facility | | $208.93 | $1,258.93 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $660.69 / $1,318.26
| Professional | | $338.84 | $660.69 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $5,623.41 / $12,302.69
| Facility | | $1,995.26 | $5,623.41 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $549.54 / $1,071.52
| Professional | | $302.00 | $549.54 | $1,071.52 |