- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $333.07 / $2,663.12 / $4,712.00
| Facility | | $333.07 | $2,663.12 | $4,712.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,836.72 / $1,836.72 / $2,122.62
| Facility | 50 | $1,836.72 | $1,836.72 | $2,122.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $247.00 / $357.63 / $1,055.86
| Professional | | $247.00 | $357.63 | $1,055.86 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $2,348.40 / $2,348.40 / $4,353.88
| Professional | 50 | $2,348.40 | $2,348.40 | $4,353.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $646.10 / $2,575.00 / $5,803.32
| Facility | | $646.10 | $2,575.00 | $5,803.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.20 / $714.11 / $2,759.20
| Professional | | $295.20 | $714.11 | $2,759.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.74 / $437.76 / $772.48
| Facility | | $336.74 | $437.76 | $772.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $552.22 / $552.22 / $748.63
| Professional | | $552.22 | $552.22 | $748.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $411.37 / $738.81 / $1,307.33
| Professional | | $411.37 | $738.81 | $1,307.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $291.41 / $614.02 / $6,679.00
| Facility | | $291.41 | $614.02 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.90 / $554.60 / $991.58
| Professional | | $438.90 | $554.60 | $991.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.00 / $780.48 / $1,044.84
| Professional | | $364.00 | $780.48 | $1,044.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,941.55 / $2,941.55 / $3,394.78
| Facility | | $2,941.55 | $2,941.55 | $3,394.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,854.00 / $9,039.00
| Facility | | $55.00 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.58 / $1,010.23 / $2,759.20
| Professional | | $437.58 | $1,010.23 | $2,759.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.52 / $593.60 / $1,314.28
| Professional | | $432.52 | $593.60 | $1,314.28 |