- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.16 / $6,408.55 / $19,276.96
| Facility | | $687.16 | $6,408.55 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,512.48 / $9,612.83 / $9,612.83
| Facility | 50 | $1,512.48 | $9,612.83 | $9,612.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $278.16 / $687.17 / $1,796.64
| Professional | | $278.16 | $687.17 | $1,796.64 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $952.85 / $2,674.71 / $2,735.34
| Professional | 50 | $952.85 | $2,674.71 | $2,735.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,024.04 / $19,760.71 / $38,223.60
| Facility | | $15,024.04 | $19,760.71 | $38,223.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.39 / $646.40 / $1,381.21
| Professional | | $294.39 | $646.40 | $1,381.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,826.60 / $7,826.60 / $7,826.60
| Facility | | $7,826.60 | $7,826.60 | $7,826.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583.62 / $1,360.65 / $2,118.33
| Professional | | $583.62 | $1,360.65 | $2,118.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.88 / $957.81 / $3,720.66
| Facility | | $319.88 | $957.81 | $3,720.66 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,225.92 / $7,225.92 / $7,529.28
| Facility | 50 | $7,225.92 | $7,225.92 | $7,529.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $914.60 / $1,643.80 / $2,778.63
| Professional | | $914.60 | $1,643.80 | $2,778.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $708.23 / $1,558.22 / $9,391.91
| Facility | | $708.23 | $1,558.22 | $9,391.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $661.57 / $1,415.53 / $2,118.33
| Professional | | $661.57 | $1,415.53 | $2,118.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $914.60 / $1,639.53 / $2,116.30
| Professional | | $914.60 | $1,639.53 | $2,116.30 |