- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.07 / $1,299.15 / $7,045.00
| Facility | | $562.07 | $1,299.15 | $7,045.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,805.60 / $3,745.76 / $3,915.18
| Facility | 50 | $2,805.60 | $3,745.76 | $3,915.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.71 / $425.91 / $1,091.73
| Professional | | $208.71 | $425.91 | $1,091.73 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $309.56 / $735.57 / $2,688.53
| Professional | 50 | $309.56 | $735.57 | $2,688.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,110.38 / $1,110.38 / $1,113.50
| Facility | | $1,110.38 | $1,110.38 | $1,113.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.56 / $427.27 / $718.18
| Professional | | $275.56 | $427.27 | $718.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.08 / $478.42 / $1,157.23
| Facility | | $191.08 | $478.42 | $1,157.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.95 / $693.83 / $841.00
| Professional | | $307.95 | $693.83 | $841.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $455.63 / $455.63 / $455.63
| Professional | 50 | $455.63 | $455.63 | $455.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $600.63 / $755.63
| Professional | | $32.34 | $600.63 | $755.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,453.10 / $4,867.04 / $5,994.73
| Facility | | $3,453.10 | $4,867.04 | $5,994.73 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,105.28 / $7,300.56 / $9,122.73
| Facility | 50 | $5,105.28 | $7,300.56 | $9,122.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.63 / $618.16 / $911.52
| Professional | | $353.63 | $618.16 | $911.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,550.00 / $12,233.00
| Facility | | $1,350.00 | $5,550.00 | $12,233.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $448.78 / $637.74 / $858.04
| Professional | | $448.78 | $637.74 | $858.04 |