- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.22 / $7,119.04 / $19,276.96
| Facility | | $678.22 | $7,119.04 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,681.60 / $4,681.60 / $5,253.60
| Facility | 50 | $4,681.60 | $4,681.60 | $5,253.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $266.00 / $422.13 / $872.58
| Professional | | $266.00 | $422.13 | $872.58 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $1,295.09 / $1,295.09 / $2,257.21
| Professional | 50 | $1,295.09 | $1,295.09 | $2,257.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,551.47 / $4,813.14 / $9,035.51
| Facility | | $3,551.47 | $4,813.14 | $9,035.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.61 / $506.17 / $724.79
| Professional | | $280.61 | $506.17 | $724.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.99 / $872.59 / $1,092.20
| Professional | | $630.99 | $872.59 | $1,092.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $339.15 / $606.83 / $2,192.80
| Facility | | $339.15 | $606.83 | $2,192.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.82 / $866.40 / $2,859.28
| Professional | | $476.82 | $866.40 | $2,859.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.47 / $714.02 / $1,038.85
| Facility | | $371.47 | $714.02 | $1,038.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.78 / $762.28 / $1,020.90
| Professional | | $579.78 | $762.28 | $1,020.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $404.00 / $1,002.90
| Professional | | $5.00 | $404.00 | $1,002.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.82 / $823.10 / $1,046.32
| Professional | | $476.82 | $823.10 | $1,046.32 |