- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $348.20 / $2,747.00 / $10,086.00
| Facility | | $348.20 | $2,747.00 | $10,086.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,730.30 / $3,856.41 / $8,086.06
| Facility | 50 | $1,730.30 | $3,856.41 | $8,086.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.00 / $352.61 / $560.15
| Professional | | $189.00 | $352.61 | $560.15 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $518.37 / $640.67 / $4,094.10
| Professional | 50 | $518.37 | $640.67 | $4,094.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.75 / $378.19 / $739.90
| Professional | | $173.75 | $378.19 | $739.90 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $260.62 / $567.29 / $914.99
| Professional | 50 | $260.62 | $567.29 | $914.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $921.94 / $1,097.55
| Facility | | $323.00 | $921.94 | $1,097.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.53 / $396.95 / $732.51
| Professional | | $191.53 | $396.95 | $732.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,144.00 / $5,784.00 / $11,062.00
| Facility | | $3,144.00 | $5,784.00 | $11,062.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.07 / $404.14 / $490.22
| Professional | | $202.07 | $404.14 | $490.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.41 / $362.39 / $557.78
| Professional | | $32.41 | $362.39 | $557.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,954.00 / $5,889.00 / $10,192.00
| Facility | | $1,954.00 | $5,889.00 | $10,192.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.60 / $457.79 / $762.58
| Professional | | $315.60 | $457.79 | $762.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.32 / $331.92 / $331.92
| Professional | | $147.32 | $331.92 | $331.92 |