- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,630.27 / $7,585.78
| Facility | | $912.01 | $2,630.27 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,621.81 / $3,548.13 / $7,244.36
| Facility | 50 | $1,621.81 | $3,548.13 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $467.74 / $1,445.44
| Professional | | $141.25 | $467.74 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $223.87 / $891.25
| Professional | | $144.54 | $223.87 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $3,019.95 / $6,165.95
| Facility | | $2,398.83 | $3,019.95 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $398.11 / $954.99
| Professional | | $173.78 | $398.11 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $562.34 / $1,445.44
| Professional | | $173.78 | $562.34 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $1,479.11 / $3,162.28
| Facility | | $251.19 | $1,479.11 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $1,230.27 / $1,862.09
| Professional | | $707.95 | $1,230.27 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $1,047.13 / $1,621.81
| Professional | | $371.54 | $1,047.13 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $1,071.52
| Professional | | $331.13 | $331.13 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $3,801.89 / $3,801.89
| Facility | | $3,235.94 | $3,801.89 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $776.25 / $1,412.54
| Professional | | $3.02 | $776.25 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $3,162.28 / $8,128.31
| Facility | | $2,041.74 | $3,162.28 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $707.95 / $1,318.26
| Professional | | $213.80 | $707.95 | $1,318.26 |