- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.24 / $2,951.73 / $8,339.00
| Facility | | $330.24 | $2,951.73 | $8,339.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.24 / $397.02 / $512.48
| Professional | | $330.24 | $397.02 | $512.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,420.00 / $5,677.23 / $12,389.06
| Facility | | $2,420.00 | $5,677.23 | $12,389.06 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,949.16 / $12,060.61 / $21,147.21
| Facility | 50 | $7,949.16 | $12,060.61 | $21,147.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $584.95 / $904.70 / $1,270.06
| Professional | | $584.95 | $904.70 | $1,270.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $836.37 / $1,186.07 / $2,853.26
| Facility | | $836.37 | $1,186.07 | $2,853.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $680.48 / $1,143.52 / $1,632.56
| Professional | | $680.48 | $1,143.52 | $1,632.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $679.91 / $1,084.35 / $2,246.66
| Facility | | $679.91 | $1,084.35 | $2,246.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $599.10 / $1,025.24 / $1,358.66
| Professional | | $599.10 | $1,025.24 | $1,358.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.55 / $1,072.08 / $7,420.28
| Facility | | $524.55 | $1,072.08 | $7,420.28 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,473.88 / $3,860.55 / $4,438.00
| Facility | 50 | $2,473.88 | $3,860.55 | $4,438.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.88 / $917.64 / $1,842.24
| Professional | | $468.88 | $917.64 | $1,842.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.52 / $917.64 / $1,414.88
| Professional | | $457.52 | $917.64 | $1,414.88 |