- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $451.88 / $4,147.00 / $8,118.00
| Facility | | $451.88 | $4,147.00 | $8,118.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,887.00 / $5,236.50 / $34,909.25
| Facility | 50 | $1,887.00 | $5,236.50 | $34,909.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.43 / $614.28 / $1,239.22
| Professional | | $296.43 | $614.28 | $1,239.22 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $516.03 / $1,419.14 / $3,138.97
| Professional | 50 | $516.03 | $1,419.14 | $3,138.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.00 / $4,358.00 / $10,713.00
| Facility | | $2,088.00 | $4,358.00 | $10,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.05 / $459.77 / $664.66
| Professional | | $325.05 | $459.77 | $664.66 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $487.57 / $682.47 / $996.99
| Professional | 50 | $487.57 | $682.47 | $996.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.00 / $10,223.00 / $15,638.00
| Facility | | $1,083.00 | $10,223.00 | $15,638.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.29 / $735.75 / $1,544.91
| Professional | | $336.29 | $735.75 | $1,544.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.26 / $790.57 / $5,187.00
| Facility | | $301.26 | $790.57 | $5,187.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $805.56 / $1,498.90 / $8,263.84
| Professional | | $805.56 | $1,498.90 | $8,263.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,426.00 / $5,048.00 / $46,908.00
| Facility | | $2,426.00 | $5,048.00 | $46,908.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $709.20 / $1,159.17 / $1,849.70
| Professional | | $709.20 | $1,159.17 | $1,849.70 |