- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,136.11 / $3,463.00 / $6,953.00
| Facility | | $1,136.11 | $3,463.00 | $6,953.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,366.50 / $6,336.30 / $10,493.11
| Facility | 50 | $4,366.50 | $6,336.30 | $10,493.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.05 / $567.36 / $2,218.00
| Professional | | $440.05 | $567.36 | $2,218.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $631.95 / $631.95 / $719.92
| Professional | | $631.95 | $631.95 | $719.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,474.00 / $4,589.00 / $6,006.00
| Facility | | $3,474.00 | $4,589.00 | $6,006.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.50 / $590.51 / $963.55
| Professional | | $473.50 | $590.51 | $963.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,773.05 / $2,314.71 / $2,475.27
| Facility | | $1,773.05 | $2,314.71 | $2,475.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.66 / $593.60 / $964.51
| Professional | | $351.66 | $593.60 | $964.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.84 / $605.29 / $2,185.57
| Professional | | $7.84 | $605.29 | $2,185.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,821.31 / $3,900.25 / $3,900.25
| Facility | | $1,821.31 | $3,900.25 | $3,900.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.88 / $505.56 / $2,731.97
| Professional | | $5.88 | $505.56 | $2,731.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $725.00 / $2,974.00 / $9,042.00
| Facility | | $725.00 | $2,974.00 | $9,042.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.93 / $580.39 / $1,031.56
| Professional | | $439.93 | $580.39 | $1,031.56 |