- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $262.24 / $1,739.82 / $6,886.00
| Facility | | $262.24 | $1,739.82 | $6,886.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,115.00 / $1,716.00 / $3,987.16
| Facility | 50 | $1,115.00 | $1,716.00 | $3,987.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.15 / $233.99 / $395.98
| Professional | | $120.15 | $233.99 | $395.98 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $484.59 / $666.68 / $1,332.00
| Professional | 50 | $484.59 | $666.68 | $1,332.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,974.00 / $2,971.00 / $7,022.00
| Facility | | $1,974.00 | $2,971.00 | $7,022.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.71 / $181.46 / $288.47
| Professional | | $139.71 | $181.46 | $288.47 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $148.76 / $169.44 / $250.49
| Professional | 50 | $148.76 | $169.44 | $250.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $684.56 / $684.56 / $2,156.40
| Facility | | $684.56 | $684.56 | $2,156.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.22 / $278.81 / $465.55
| Professional | | $148.22 | $278.81 | $465.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.28 / $262.24 / $451.14
| Facility | | $136.28 | $262.24 | $451.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.25 / $278.13 / $476.80
| Professional | | $167.25 | $278.13 | $476.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,361.00 / $2,537.00 / $3,681.00
| Facility | | $1,361.00 | $2,537.00 | $3,681.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.76 / $370.26 / $565.86
| Professional | | $275.76 | $370.26 | $565.86 |