- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $497.25 / $2,173.00 / $5,596.57
| Facility | | $497.25 | $2,173.00 | $5,596.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,259.50 / $3,259.50 / $9,052.15
| Facility | 50 | $3,259.50 | $3,259.50 | $9,052.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.14 / $438.64 / $2,150.00
| Professional | | $366.14 | $438.64 | $2,150.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $206.57 / $619.71 / $880.76
| Professional | 50 | $206.57 | $619.71 | $880.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.06 / $496.06 / $647.04
| Professional | | $496.06 | $496.06 | $647.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,072.00 / $3,931.00 / $5,258.00
| Facility | | $3,072.00 | $3,931.00 | $5,258.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.35 / $546.39 / $732.29
| Professional | | $466.35 | $546.39 | $732.29 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $561.20 / $699.52 / $880.39
| Professional | 50 | $561.20 | $699.52 | $880.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $973.17 / $17,444.00 / $17,668.00
| Facility | | $973.17 | $17,444.00 | $17,668.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.62 / $547.41 / $784.94
| Professional | | $356.62 | $547.41 | $784.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $543.27 / $974.53
| Professional | | $7.41 | $543.27 | $974.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,158.16 / $2,158.16 / $2,158.16
| Facility | | $2,158.16 | $2,158.16 | $2,158.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.04 / $438.80 / $1,485.89
| Professional | | $5.04 | $438.80 | $1,485.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,282.00 / $2,299.00 / $7,221.00
| Facility | | $1,282.00 | $2,299.00 | $7,221.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.10 / $494.17 / $762.27
| Professional | | $377.10 | $494.17 | $762.27 |