- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $3,162.28 / $5,623.41
| Facility | | $446.68 | $3,162.28 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,137.96 / $2,511.89 / $7,943.28
| Facility | 50 | $2,137.96 | $2,511.89 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $562.34 / $1,047.13
| Professional | | $371.54 | $562.34 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $478.63 / $616.60
| Professional | | $354.81 | $478.63 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,041.74 / $4,168.69
| Facility | | $676.08 | $2,041.74 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $501.19 / $812.83
| Professional | | $389.05 | $501.19 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $575.44 / $758.58
| Professional | | $416.87 | $575.44 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $602.56 / $1,023.29
| Professional | | $354.81 | $602.56 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $912.01 / $26,302.68
| Facility | | $380.19 | $912.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,691.53 / $2,691.53 / $2,691.53
| Facility | 50 | $2,691.53 | $2,691.53 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $741.31 / $3,801.89
| Professional | | $446.68 | $741.31 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,818.38 / $4,677.35
| Facility | | $1,819.70 | $2,818.38 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $524.81 / $870.96
| Professional | | $371.54 | $524.81 | $870.96 |