- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.86 / $982.40 / $2,144.34
| Facility | | $279.86 | $982.40 | $2,144.34 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,274.40 / $5,274.40 / $5,274.40
| Facility | 50 | $5,274.40 | $5,274.40 | $5,274.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $273.88 / $369.63 / $1,057.32
| Professional | | $273.88 | $369.63 | $1,057.32 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $7,597.80 / $7,597.80 / $7,597.80
| Professional | 50 | $7,597.80 | $7,597.80 | $7,597.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $634.37 / $809.29 / $1,090.74
| Professional | | $634.37 | $809.29 | $1,090.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.22 / $540.51 / $1,005.29
| Facility | | $338.22 | $540.51 | $1,005.29 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $858.99 / $858.99 / $2,790.19
| Facility | 50 | $858.99 | $858.99 | $2,790.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $453.78 / $1,001.84 / $2,859.28
| Professional | | $453.78 | $1,001.84 | $2,859.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.67 / $743.18 / $1,007.91
| Facility | | $470.67 | $743.18 | $1,007.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.78 / $762.28 / $1,007.91
| Professional | | $579.78 | $762.28 | $1,007.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.07 / $560.86 / $743.29
| Professional | | $392.07 | $560.86 | $743.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,714.00 / $2,714.00 / $2,714.00
| Facility | | $2,714.00 | $2,714.00 | $2,714.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.97 / $756.30 / $1,046.70
| Professional | | $415.97 | $756.30 | $1,046.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $546.60 / $668.80 / $886.30
| Professional | | $546.60 | $668.80 | $886.30 |