- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,083.01 / $6,304.12 / $16,762.57
| Facility | | $3,083.01 | $6,304.12 | $16,762.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,540.79 / $4,540.79 / $4,540.79
| Facility | 50 | $4,540.79 | $4,540.79 | $4,540.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.29 / $389.00 / $1,397.49
| Professional | | $237.29 | $389.00 | $1,397.49 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $118.65 / $191.36 / $698.75
| Professional | 52 | $118.65 | $191.36 | $698.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.78 / $360.12 / $555.01
| Professional | | $227.78 | $360.12 | $555.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,725.11 / $8,845.35 / $17,109.75
| Facility | | $6,725.11 | $8,845.35 | $17,109.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.81 / $477.75 / $769.51
| Professional | | $249.81 | $477.75 | $769.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $504.43 / $831.13 / $1,344.20
| Professional | | $504.43 | $831.13 | $1,344.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $355.94 / $669.74 / $5,243.53
| Facility | | $355.94 | $669.74 | $5,243.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $531.30 / $968.26 / $2,434.00
| Professional | | $531.30 | $968.26 | $2,434.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.79 / $758.08 / $1,344.20
| Facility | | $373.79 | $758.08 | $1,344.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $640.91 / $1,012.04 / $1,455.66
| Professional | | $640.91 | $1,012.04 | $1,455.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,700.00 / $6,178.00 / $8,632.00
| Facility | | $4,700.00 | $6,178.00 | $8,632.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $531.30 / $952.68 / $1,216.82
| Professional | | $531.30 | $952.68 | $1,216.82 |