- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $381.06 / $2,507.00 / $6,962.00
| Facility | | $381.06 | $2,507.00 | $6,962.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $892.16 / $2,530.50 / $4,676.00
| Facility | 50 | $892.16 | $2,530.50 | $4,676.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $255.31 / $340.79 / $900.00
| Professional | | $255.31 | $340.79 | $900.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $637.74 / $1,395.45 / $1,539.57
| Professional | 50 | $637.74 | $1,395.45 | $1,539.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,232.00 / $4,257.00 / $9,640.00
| Facility | | $2,232.00 | $4,257.00 | $9,640.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $306.38 / $407.23 / $632.51
| Professional | | $306.38 | $407.23 | $632.51 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $459.57 / $610.84 / $948.76
| Professional | 50 | $459.57 | $610.84 | $948.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,652.00 / $5,249.00 / $6,727.00
| Facility | | $2,652.00 | $5,249.00 | $6,727.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.85 / $469.94 / $757.39
| Professional | | $284.85 | $469.94 | $757.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $255.31 / $497.85 / $2,845.00
| Facility | | $255.31 | $497.85 | $2,845.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $388.52 / $757.72 / $2,859.28
| Professional | | $388.52 | $757.72 | $2,859.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,644.00 / $2,959.00 / $5,829.00
| Facility | | $1,644.00 | $2,959.00 | $5,829.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $387.96 / $508.64 / $804.83
| Professional | | $387.96 | $508.64 | $804.83 |