- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $633.50 / $2,633.00 / $7,670.00
| Facility | | $633.50 | $2,633.00 | $7,670.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $633.50 / $2,434.00 / $7,670.00
| Facility | 50 | $633.50 | $2,434.00 | $7,670.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.22 / $350.91 / $899.79
| Professional | | $150.22 | $350.91 | $899.79 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $139.72 / $775.11 / $2,233.13
| Professional | 50 | $139.72 | $775.11 | $2,233.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.16 / $2,286.10 / $3,616.69
| Facility | | $601.16 | $2,286.10 | $3,616.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.51 / $231.82 / $347.73
| Professional | | $127.51 | $231.82 | $347.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,049.52 / $3,049.52 / $3,049.52
| Facility | | $3,049.52 | $3,049.52 | $3,049.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.60 / $359.89 / $766.69
| Professional | | $150.60 | $359.89 | $766.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.35 / $363.03 / $3,483.84
| Facility | | $160.35 | $363.03 | $3,483.84 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,933.80 / $3,933.80 / $3,933.80
| Facility | 50 | $3,933.80 | $3,933.80 | $3,933.80 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $775.66 / $775.66 / $775.66
| Facility | 52 | $775.66 | $775.66 | $775.66 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $193.91 / $193.91 / $193.91
| Facility | 53 | $193.91 | $193.91 | $193.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.35 / $582.75 / $4,715.39
| Professional | | $427.35 | $582.75 | $4,715.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,343.00 / $3,339.00 / $5,838.00
| Facility | | $2,343.00 | $3,339.00 | $5,838.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $412.30 / $507.62 / $857.04
| Professional | | $412.30 | $507.62 | $857.04 |