- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.32 / $1,277.00 / $9,034.00
| Facility | | $521.32 | $1,277.00 | $9,034.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,624.50 / $1,624.50 / $1,624.50
| Facility | 50 | $1,624.50 | $1,624.50 | $1,624.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.62 / $519.71 / $707.26
| Professional | | $356.62 | $519.71 | $707.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,150.23 / $2,150.23 / $2,580.29
| Facility | | $2,150.23 | $2,150.23 | $2,580.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $483.43 / $684.40 / $905.82
| Professional | | $483.43 | $684.40 | $905.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,832.32 / $1,832.32 / $1,832.32
| Facility | | $1,832.32 | $1,832.32 | $1,832.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $461.21 / $729.85 / $1,097.52
| Professional | | $461.21 | $729.85 | $1,097.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $980.00 / $1,650.00 / $4,064.00
| Facility | | $980.00 | $1,650.00 | $4,064.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $531.75 / $659.36 / $1,157.43
| Professional | | $531.75 | $659.36 | $1,157.43 |