- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.70 / $2,663.12 / $5,454.00
| Facility | | $275.70 | $2,663.12 | $5,454.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,473.31 / $6,473.31 / $6,473.31
| Facility | 50 | $6,473.31 | $6,473.31 | $6,473.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.86 / $298.99 / $608.16
| Professional | | $206.86 | $298.99 | $608.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $620.24 / $3,764.00 / $12,379.00
| Facility | | $620.24 | $3,764.00 | $12,379.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.72 / $629.16 / $2,391.52
| Professional | | $263.72 | $629.16 | $2,391.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.98 / $387.37 / $683.57
| Facility | | $297.98 | $387.37 | $683.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.48 / $560.07 / $797.36
| Professional | | $399.48 | $560.07 | $797.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $411.58 / $648.76 / $1,296.78
| Professional | | $411.58 | $648.76 | $1,296.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.39 / $543.34 / $6,679.00
| Facility | | $257.39 | $543.34 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.70 / $484.85 / $808.89
| Professional | | $383.70 | $484.85 | $808.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $324.54 / $690.23 / $920.28
| Professional | | $324.54 | $690.23 | $920.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.73 / $1,234.97 / $13,852.05
| Facility | | $174.73 | $1,234.97 | $13,852.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.91 / $392.60 / $399.12
| Professional | | $366.91 | $392.60 | $399.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,740.48 / $4,249.00 / $16,394.00
| Facility | | $1,740.48 | $4,249.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $397.70 / $979.71 / $2,391.52
| Professional | | $397.70 | $979.71 | $2,391.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.58 / $538.60 / $1,052.05
| Professional | | $392.58 | $538.60 | $1,052.05 |