- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.42 / $3,233.52 / $9,169.04
| Facility | | $226.42 | $3,233.52 | $9,169.04 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,174.00 / $4,228.29 / $6,750.00
| Facility | 50 | $2,174.00 | $4,228.29 | $6,750.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.22 / $152.72 / $226.42
| Professional | | $151.22 | $152.72 | $226.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,436.64 / $5,357.37 / $8,430.54
| Facility | | $3,436.64 | $5,357.37 | $8,430.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.44 / $196.97 / $205.22
| Professional | | $149.44 | $196.97 | $205.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.91 / $204.31 / $251.61
| Professional | | $161.91 | $204.31 | $251.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.72 / $324.00 / $4,132.00
| Facility | | $152.72 | $324.00 | $4,132.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,450.73 / $1,900.09 / $3,092.81
| Facility | 50 | $1,450.73 | $1,900.09 | $3,092.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.51 / $210.13 / $1,429.86
| Professional | | $145.51 | $210.13 | $1,429.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $498.00 / $1,928.00 / $3,790.62
| Facility | | $498.00 | $1,928.00 | $3,790.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.43 / $178.79 / $247.37
| Professional | | $137.43 | $178.79 | $247.37 |