- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $7,943.28 / $14,454.40
| Facility | | $1,288.25 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,456.54 / $9,332.54 / $9,332.54
| Facility | 50 | $6,456.54 | $9,332.54 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $724.44 / $3,548.13
| Professional | | $501.19 | $724.44 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $691.83 / $1,698.24 / $8,709.64
| Professional | 50 | $691.83 | $1,698.24 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $741.31
| Professional | | $371.54 | $371.54 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $354.81 / $758.58 / $1,318.26
| Professional | 50 | $354.81 | $758.58 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $6,606.93 / $12,882.50
| Facility | | $5,128.61 | $6,606.93 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $912.01 / $1,230.27
| Professional | | $537.03 | $912.01 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $1,288.25 / $1,819.70
| Professional | | $512.86 | $1,288.25 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $1,023.29 / $3,890.45
| Facility | | $512.86 | $1,023.29 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $1,862.09
| Facility | 50 | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $1,288.25 / $4,677.35
| Professional | | $724.44 | $1,288.25 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,412.54 / $1,778.28
| Professional | | $1,174.90 | $1,412.54 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,380.38 / $1,698.24
| Professional | | $1,230.27 | $1,380.38 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $3,162.28 / $8,128.31
| Facility | | $2,570.40 | $3,162.28 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $1,096.48 / $1,479.11
| Professional | | $660.69 | $1,096.48 | $1,479.11 |