- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,364.12 / $7,088.65 / $10,632.17
| Facility | | $1,364.12 | $7,088.65 | $10,632.17 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,984.11 / $7,984.11 / $7,984.11
| Facility | 50 | $7,984.11 | $7,984.11 | $7,984.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.43 / $696.33 / $1,398.17
| Professional | | $296.43 | $696.33 | $1,398.17 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $516.03 / $516.03 / $6,996.47
| Professional | 50 | $516.03 | $516.03 | $6,996.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,905.00 / $61,727.00 / $77,978.00
| Facility | | $12,905.00 | $61,727.00 | $77,978.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.18 / $685.90 / $976.13
| Professional | | $314.18 | $685.90 | $976.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $471.27 / $1,028.84 / $1,464.20
| Professional | 50 | $471.27 | $1,028.84 | $1,464.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.00 / $14,296.23 / $14,296.23
| Facility | | $843.00 | $14,296.23 | $14,296.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.78 / $868.26 / $2,346.89
| Professional | | $540.78 | $868.26 | $2,346.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,363.21 / $6,595.00 / $6,730.00
| Facility | | $5,363.21 | $6,595.00 | $6,730.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $613.04 / $1,425.26 / $1,794.80
| Professional | | $613.04 | $1,425.26 | $1,794.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,687.02 / $4,687.02 / $4,786.08
| Facility | | $4,687.02 | $4,687.02 | $4,786.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $481.92 / $645.77 / $752.40
| Professional | | $481.92 | $645.77 | $752.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,943.00 / $10,336.00 / $17,069.00
| Facility | | $6,943.00 | $10,336.00 | $17,069.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $672.83 / $1,359.51 / $2,210.12
| Professional | | $672.83 | $1,359.51 | $2,210.12 |