- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,100.00 / $6,506.00 / $10,883.70
| Facility | | $2,100.00 | $6,506.00 | $10,883.70 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,506.00 / $8,184.00 / $12,209.00
| Facility | 50 | $6,506.00 | $8,184.00 | $12,209.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.89 / $500.69 / $1,838.00
| Professional | | $361.89 | $500.69 | $1,838.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.27 / $436.64 / $646.13
| Professional | | $374.27 | $436.64 | $646.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $781.60 / $3,103.93 / $5,113.62
| Facility | | $781.60 | $3,103.93 | $5,113.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.96 / $510.81 / $593.80
| Professional | | $446.96 | $510.81 | $593.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.00 / $3,216.04 / $5,269.46
| Facility | | $630.00 | $3,216.04 | $5,269.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $365.97 / $498.00 / $932.17
| Professional | | $365.97 | $498.00 | $932.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $406.49 / $508.20 / $7,167.00
| Facility | | $406.49 | $508.20 | $7,167.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,630.09 / $4,630.09 / $5,628.35
| Facility | 50 | $4,630.09 | $4,630.09 | $5,628.35 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $108.82 / $1,537.78 / $1,537.78
| Facility | AS | $108.82 | $1,537.78 | $1,537.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.50 / $477.75 / $3,959.35
| Professional | | $370.50 | $477.75 | $3,959.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,100.00 / $7,104.00 / $11,396.00
| Facility | | $4,100.00 | $7,104.00 | $11,396.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.75 / $450.00 / $831.27
| Professional | | $360.75 | $450.00 | $831.27 |