- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.24 / $398.88 / $2,168.00
| Facility | | $143.24 | $398.88 | $2,168.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.37 / $347.65 / $562.91
| Professional | | $139.37 | $347.65 | $562.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,125.01 / $3,936.29 / $7,808.13
| Facility | | $2,125.01 | $3,936.29 | $7,808.13 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,402.57 / $6,679.66 / $11,712.19
| Facility | 50 | $4,402.57 | $6,679.66 | $11,712.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.51 / $650.38 / $1,326.80
| Professional | | $291.51 | $650.38 | $1,326.80 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $427.83 / $905.30 / $1,990.20
| Professional | 50 | $427.83 | $905.30 | $1,990.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $986.62 / $1,399.88 / $3,367.60
| Facility | | $986.62 | $1,399.88 | $3,367.60 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $199.19 / $199.19 / $199.19
| Facility | 52 | $199.19 | $199.19 | $199.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.22 / $661.00 / $1,585.50
| Professional | | $315.22 | $661.00 | $1,585.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $802.47 / $1,279.82 / $2,651.65
| Facility | | $802.47 | $1,279.82 | $2,651.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.10 / $590.48 / $1,342.54
| Professional | | $312.10 | $590.48 | $1,342.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.26 / $484.30 / $2,317.61
| Facility | | $201.26 | $484.30 | $2,317.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,758.36 / $2,990.32 / $3,139.32
| Facility | 50 | $2,758.36 | $2,990.32 | $3,139.32 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $534.08 / $534.08 / $534.08
| Facility | 52 | $534.08 | $534.08 | $534.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.44 / $818.84 / $1,671.22
| Professional | | $438.44 | $818.84 | $1,671.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $4,746.00 / $8,812.00
| Facility | | $2,412.00 | $4,746.00 | $8,812.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.15 / $746.33 / $1,565.16
| Professional | | $399.15 | $746.33 | $1,565.16 |