- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $618.20 / $1,698.00 / $6,326.81
| Facility | | $618.20 | $1,698.00 | $6,326.81 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,488.61 / $6,753.60 / $6,753.60
| Facility | 50 | $2,488.61 | $6,753.60 | $6,753.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $391.54 / $618.20 / $750.01
| Professional | | $391.54 | $618.20 | $750.01 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $1,211.40 / $1,211.40 / $1,211.40
| Professional | 50 | $1,211.40 | $1,211.40 | $1,211.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.67 / $511.53 / $816.38
| Professional | | $244.67 | $511.53 | $816.38 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $548.05 / $548.05 / $548.05
| Professional | 50 | $548.05 | $548.05 | $548.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,695.45 / $3,135.23 / $4,778.22
| Facility | | $1,695.45 | $3,135.23 | $4,778.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $479.72 / $595.98 / $738.36
| Professional | | $479.72 | $595.98 | $738.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.38 / $1,490.38 / $1,490.38
| Facility | | $410.38 | $1,490.38 | $1,490.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $725.00 / $725.00 / $725.00
| Facility | | $725.00 | $725.00 | $725.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.13 / $567.51 / $747.37
| Professional | | $427.13 | $567.51 | $747.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $746.00 / $2,415.00 / $7,085.00
| Facility | | $746.00 | $2,415.00 | $7,085.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $372.02 / $504.30 / $889.77
| Professional | | $372.02 | $504.30 | $889.77 |