- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,949.84 / $4,073.80
| Facility | | $467.74 | $1,949.84 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,165.95 / $7,079.46 / $9,120.11
| Facility | 50 | $6,165.95 | $7,079.46 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $245.47 / $912.01
| Professional | | $93.33 | $245.47 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $144.54 / $812.83 / $2,398.83
| Professional | 50 | $144.54 | $812.83 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $114.82 / $223.87
| Professional | | $85.11 | $114.82 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $128.82 / $138.04 / $1,778.28
| Professional | 50 | $128.82 | $138.04 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,951.21 / $3,801.89
| Facility | | $1,548.82 | $2,951.21 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $316.23 / $1,047.13
| Professional | | $117.49 | $316.23 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,258.93 / $1,258.93
| Facility | | $1,258.93 | $1,258.93 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $316.23 / $851.14
| Professional | | $112.20 | $316.23 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $5,495.41 / $5,495.41
| Facility | | $54.95 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,073.80 / $4,786.30 / $4,786.30
| Professional | | $4,073.80 | $4,786.30 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,479.11 / $2,884.03
| Facility | | $741.31 | $1,479.11 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $416.87 / $954.99
| Professional | | $100.00 | $416.87 | $954.99 |