- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.38 / $2,220.75 / $5,407.49
| Facility | | $562.38 | $2,220.75 | $5,407.49 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,208.33 / $3,208.33 / $3,208.33
| Facility | 50 | $3,208.33 | $3,208.33 | $3,208.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.04 / $368.72 / $752.32
| Professional | | $114.04 | $368.72 | $752.32 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $114.04 / $114.04 / $862.00
| Professional | 50 | $114.04 | $114.04 | $862.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.87 / $374.69 / $662.38
| Professional | | $244.87 | $374.69 | $662.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $220.13 / $472.59 / $860.74
| Facility | | $220.13 | $472.59 | $860.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.31 / $428.26 / $710.32
| Professional | | $353.31 | $428.26 | $710.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $573.11
| Professional | | $32.34 | $32.34 | $573.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,884.56 / $5,546.60 / $7,080.21
| Facility | | $3,884.56 | $5,546.60 | $7,080.21 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,407.41 / $8,319.90 / $11,041.11
| Facility | 50 | $5,407.41 | $8,319.90 | $11,041.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.44 / $607.96 / $747.15
| Professional | | $358.44 | $607.96 | $747.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,150.00 / $5,550.00 / $12,233.00
| Facility | | $1,150.00 | $5,550.00 | $12,233.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $419.52 / $561.58 / $816.96
| Professional | | $419.52 | $561.58 | $816.96 |