- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.00 / $3,739.18 / $10,843.00
| Facility | | $330.00 | $3,739.18 | $10,843.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,842.37 / $5,482.40 / $7,736.63
| Facility | 50 | $2,842.37 | $5,482.40 | $7,736.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.20 / $330.00 / $509.27
| Professional | | $241.20 | $330.00 | $509.27 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $859.62 / $859.62 / $859.62
| Professional | 50 | $859.62 | $859.62 | $859.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $202.85 / $206.11 / $323.00
| Facility | | $202.85 | $206.11 | $323.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.31 / $428.21 / $673.98
| Professional | | $275.31 | $428.21 | $673.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,561.00 / $4,821.00 / $9,360.00
| Facility | | $2,561.00 | $4,821.00 | $9,360.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.26 / $276.70 / $486.71
| Professional | | $258.26 | $276.70 | $486.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.21 / $348.04 / $511.79
| Professional | | $33.21 | $348.04 | $511.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,681.00 / $5,811.00 / $10,057.00
| Facility | | $1,681.00 | $5,811.00 | $10,057.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.27 / $436.08 / $760.55
| Professional | | $301.27 | $436.08 | $760.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.37 / $293.37 / $293.37
| Professional | | $221.37 | $293.37 | $293.37 |