- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,237.34 / $9,062.00 / $18,276.00
| Facility | | $1,237.34 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,676.00 / $7,676.00 / $7,676.00
| Facility | 50 | $7,676.00 | $7,676.00 | $7,676.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $677.44 / $1,012.49 / $1,237.34
| Professional | | $677.44 | $1,012.49 | $1,237.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $950.61 / $950.61 / $1,582.88
| Professional | | $950.61 | $950.61 | $1,582.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,483.92 / $4,657.84 / $7,666.70
| Facility | | $2,483.92 | $4,657.84 | $7,666.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $884.29 / $1,082.00 / $1,902.48
| Professional | | $884.29 | $1,082.00 | $1,902.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.00 / $815.00 / $1,677.54
| Facility | | $815.00 | $815.00 | $1,677.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $722.31 / $1,091.19 / $2,329.35
| Professional | | $722.31 | $1,091.19 | $2,329.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $839.00 / $1,172.61 / $1,670.42
| Facility | | $839.00 | $1,172.61 | $1,670.42 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,258.50 / $1,525.82 / $2,278.03
| Facility | 50 | $1,258.50 | $1,525.82 | $2,278.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,062.00 / $1,062.00 / $1,376.31
| Professional | | $1,062.00 | $1,062.00 | $1,376.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.50 / $676.57 / $1,048.76
| Professional | | $103.50 | $676.57 | $1,048.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $10,257.00 / $16,249.00
| Facility | | $1,258.00 | $10,257.00 | $16,249.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $742.19 / $903.06 / $1,532.87
| Professional | | $742.19 | $903.06 | $1,532.87 |