- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,981.07 / $7,079.46
| Facility | | $1,348.96 | $3,981.07 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,365.16 / $9,120.11 / $10,471.29
| Facility | 50 | $4,365.16 | $9,120.11 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $776.25 / $2,511.89
| Professional | | $467.74 | $776.25 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $549.54 / $954.99
| Professional | | $416.87 | $549.54 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $6,025.60 / $7,762.47
| Facility | | $3,715.35 | $6,025.60 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $616.60 / $1,000.00
| Professional | | $478.63 | $616.60 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $2,454.71 / $2,454.71
| Facility | | $2,454.71 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $602.56 / $1,000.00
| Professional | | $354.81 | $602.56 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $602.56 / $2,238.72
| Professional | | $7.76 | $602.56 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $1,819.70 / $1,819.70
| Facility | | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $741.31 / $2,754.23
| Professional | | $741.31 | $741.31 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $1,096.48
| Professional | | $501.19 | $501.19 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,691.53 / $9,120.11
| Facility | | $1,096.48 | $2,691.53 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $562.34 / $933.25
| Professional | | $436.52 | $562.34 | $933.25 |