- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,229.77 / $11,188.80 / $28,822.14
| Facility | | $3,229.77 | $11,188.80 | $28,822.14 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,311.55 / $13,394.39 / $29,011.55
| Facility | 50 | $5,311.55 | $13,394.39 | $29,011.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.89 / $484.00 / $1,524.50
| Professional | | $361.89 | $484.00 | $1,524.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $401.68 / $482.02 / $723.52
| Professional | | $401.68 | $482.02 | $723.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.00 / $7,157.00 / $30,357.00
| Facility | | $611.00 | $7,157.00 | $30,357.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $48.91 / $48.91 / $48.91
| Facility | AS | $48.91 | $48.91 | $48.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.00 / $567.55 / $854.13
| Professional | | $378.00 | $567.55 | $854.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,743.00 / $12,190.00 / $22,833.00
| Facility | | $4,743.00 | $12,190.00 | $22,833.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.19 / $398.49 / $527.09
| Professional | | $190.19 | $398.49 | $527.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.68 / $376.45 / $593.62
| Professional | | $50.68 | $376.45 | $593.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,595.00 / $12,291.00 / $18,694.00
| Facility | | $3,595.00 | $12,291.00 | $18,694.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.12 / $458.25 / $827.13
| Professional | | $338.12 | $458.25 | $827.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $337.54 / $337.54 / $364.96
| Professional | | $337.54 | $337.54 | $364.96 |