- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.41 / $9,544.15 / $20,928.72
| Facility | | $505.41 | $9,544.15 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,495.72 / $7,495.72 / $7,495.72
| Facility | 50 | $7,495.72 | $7,495.72 | $7,495.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.53 / $665.79 / $2,266.69
| Professional | | $400.53 | $665.79 | $2,266.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,104.22 / $6,659.73 / $12,985.98
| Facility | | $5,104.22 | $6,659.73 | $12,985.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $424.66 / $741.69 / $1,019.80
| Professional | | $424.66 | $741.69 | $1,019.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,539.00 / $1,539.00 / $1,539.00
| Facility | | $1,539.00 | $1,539.00 | $1,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $955.95 / $1,241.69 / $1,560.15
| Professional | | $955.95 | $1,241.69 | $1,560.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.64 / $837.35 / $4,217.00
| Facility | | $480.64 | $837.35 | $4,217.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $684.02 / $1,040.73 / $1,365.48
| Professional | | $684.02 | $1,040.73 | $1,365.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $935.96 / $1,261.06 / $1,908.09
| Facility | | $935.96 | $1,261.06 | $1,908.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $775.00 / $1,014.76 / $1,422.53
| Professional | | $775.00 | $1,014.76 | $1,422.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $775.88 / $1,082.63 / $1,356.05
| Professional | | $775.88 | $1,082.63 | $1,356.05 |