- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $4,570.88 / $8,709.64
| Facility | | $467.74 | $4,570.88 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $457.09 / $1,202.26
| Professional | | $371.54 | $457.09 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $7,585.78 / $17,378.01
| Facility | | $2,630.27 | $7,585.78 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $9,120.11 / $16,218.10 / $40,738.03
| Facility | 50 | $9,120.11 | $16,218.10 | $40,738.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $1,000.00 / $1,621.81
| Professional | | $676.08 | $1,000.00 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,548.82 / $3,715.35
| Facility | | $1,096.48 | $1,548.82 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $912.01 / $912.01 / $912.01
| Facility | 22 | $912.01 | $912.01 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $1,348.96 / $1,995.26
| Professional | | $870.96 | $1,348.96 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,513.56 / $2,951.21
| Facility | | $1,202.26 | $1,513.56 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $812.83 / $1,122.02 / $1,698.24
| Professional | | $812.83 | $1,122.02 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $2,511.89 / $7,762.47
| Facility | | $512.86 | $2,511.89 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.55 / $2,754.23 / $5,128.61
| Facility | 50 | $0.55 | $2,754.23 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $851.14 / $1,737.80
| Professional | | $512.86 | $851.14 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,248.07 / $10,000.00
| Facility | | $2,884.03 | $5,248.07 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $870.96 / $1,698.24
| Professional | | $501.19 | $870.96 | $1,698.24 |