- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.55 / $3,276.00 / $10,632.00
| Facility | | $213.55 | $3,276.00 | $10,632.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $705.77 / $2,444.78 / $2,786.28
| Facility | 50 | $705.77 | $2,444.78 | $2,786.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.21 / $217.36 / $443.14
| Professional | | $122.21 | $217.36 | $443.14 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $342.56 / $377.10 / $443.98
| Professional | 50 | $342.56 | $377.10 | $443.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.94 / $247.65 / $299.63
| Professional | | $76.94 | $247.65 | $299.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.28 / $191.19 / $323.00
| Facility | | $179.28 | $191.19 | $323.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.31 / $247.45 / $498.21
| Professional | | $131.31 | $247.45 | $498.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,735.00 / $2,881.00 / $6,066.00
| Facility | | $1,735.00 | $2,881.00 | $6,066.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.39 / $187.74 / $307.66
| Professional | | $111.39 | $187.74 | $307.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.28 / $230.79 / $396.01
| Professional | | $32.28 | $230.79 | $396.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.00 / $3,611.00 / $6,550.00
| Facility | | $803.00 | $3,611.00 | $6,550.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.80 / $264.30 / $468.19
| Professional | | $192.80 | $264.30 | $468.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.24 / $208.86 / $208.86
| Professional | | $119.24 | $208.86 | $208.86 |