- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $11,748.98 / $25,703.96
| Facility | | $3,890.45 | $11,748.98 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,079.46 / $19,498.45 / $87,096.36
| Facility | 50 | $7,079.46 | $19,498.45 | $87,096.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $10,715.19 / $17,782.79
| Facility | | $6,025.60 | $10,715.19 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $6,760.83 / $24,547.09
| Facility | | $66.07 | $6,760.83 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $3,981.07 / $4,786.30
| Facility | | $3,981.07 | $3,981.07 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $676.08 / $1,023.29
| Professional | | $660.69 | $676.08 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $724.44 / $1,445.44
| Professional | | $549.54 | $724.44 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $50,118.72 / $50,118.72
| Facility | | $18,197.01 | $50,118.72 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $831.76 / $1,288.25
| Facility | | $602.56 | $831.76 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $10,964.78 / $10,964.78
| Facility | | $10,964.78 | $10,964.78 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $14,454.40 / $29,512.09
| Facility | | $7,762.47 | $14,454.40 | $29,512.09 |