- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $976.13 / $976.13 / $6,716.00
| Facility | | $976.13 | $976.13 | $6,716.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $828.97 / $978.83 / $1,608.43
| Professional | | $828.97 | $978.83 | $1,608.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,036.96 / $5,283.41 / $9,450.11
| Facility | | $3,036.96 | $5,283.41 | $9,450.11 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,328.39 / $8,084.34 / $14,175.17
| Facility | 50 | $5,328.39 | $8,084.34 | $14,175.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,442.36 / $1,988.64 / $3,215.47
| Professional | | $1,442.36 | $1,988.64 | $3,215.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,269.57 / $3,220.20 / $7,746.62
| Facility | | $2,269.57 | $3,220.20 | $7,746.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,545.14 / $2,536.00 / $3,997.64
| Professional | | $1,545.14 | $2,536.00 | $3,997.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,845.95 / $2,944.03 / $6,099.70
| Facility | | $1,845.95 | $2,944.03 | $6,099.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,337.00 / $2,153.78 / $3,666.07
| Professional | | $1,337.00 | $2,153.78 | $3,666.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,048.59 / $1,713.48 / $6,043.72
| Facility | | $1,048.59 | $1,713.48 | $6,043.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $997.00 / $1,723.44 / $3,741.39
| Professional | | $997.00 | $1,723.44 | $3,741.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,091.95 / $1,852.94 / $3,559.13
| Professional | | $1,091.95 | $1,852.94 | $3,559.13 |