- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,522.10 / $8,399.52 / $22,684.21
| Facility | | $2,522.10 | $8,399.52 | $22,684.21 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,373.20 / $7,116.99 / $9,707.54
| Facility | 50 | $5,373.20 | $7,116.99 | $9,707.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.20 / $616.97 / $5,131.10
| Professional | | $404.20 | $616.97 | $5,131.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,000.00 / $6,765.00 / $13,776.56
| Facility | | $4,000.00 | $6,765.00 | $13,776.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.34 / $809.76 / $1,260.08
| Professional | | $383.34 | $809.76 | $1,260.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,208.42 / $3,208.42 / $4,122.88
| Facility | | $3,208.42 | $3,208.42 | $4,122.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.40 / $589.32 / $1,078.08
| Professional | | $471.40 | $589.32 | $1,078.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.95 / $565.33 / $918.90
| Facility | | $420.95 | $565.33 | $918.90 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $833.76 / $848.00 / $1,170.15
| Facility | 50 | $833.76 | $848.00 | $1,170.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,982.34 / $2,838.69 / $3,329.76
| Professional | | $1,982.34 | $2,838.69 | $3,329.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $337.82 / $457.01 / $709.66
| Professional | | $337.82 | $457.01 | $709.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,959.00 / $23,485.00
| Facility | | $2,912.00 | $16,959.00 | $23,485.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $388.48 / $565.52 / $1,053.86
| Professional | | $388.48 | $565.52 | $1,053.86 |