- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $6,769.22 / $18,600.00
| Facility | | $1,500.00 | $6,769.22 | $18,600.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,732.50 / $9,208.50 / $28,784.81
| Facility | 50 | $4,732.50 | $9,208.50 | $28,784.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.88 / $465.50 / $609.28
| Professional | | $361.88 | $465.50 | $609.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.32 / $519.25 / $559.19
| Professional | | $471.32 | $519.25 | $559.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,813.00 / $12,220.00 / $19,065.61
| Facility | | $7,813.00 | $12,220.00 | $19,065.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.45 / $558.60 / $682.54
| Professional | | $415.45 | $558.60 | $682.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,321.00 / $2,321.00 / $2,321.00
| Facility | | $2,321.00 | $2,321.00 | $2,321.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $419.27 / $546.04 / $713.48
| Professional | | $419.27 | $546.04 | $713.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.23 / $604.54 / $10,232.00
| Facility | | $442.23 | $604.54 | $10,232.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,135.36 / $6,135.36 / $10,193.71
| Facility | 50 | $6,135.36 | $6,135.36 | $10,193.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,537.78 / $1,537.78 / $1,537.78
| Facility | AS | $1,537.78 | $1,537.78 | $1,537.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.45 / $518.16 / $3,959.35
| Professional | | $383.45 | $518.16 | $3,959.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $7,074.00 / $14,139.00
| Facility | | $1,851.00 | $7,074.00 | $14,139.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.50 / $473.68 / $717.82
| Professional | | $370.50 | $473.68 | $717.82 |