- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $5,128.61 / $9,772.37
| Facility | | $1,318.26 | $5,128.61 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $11,748.98 / $11,748.98 / $11,748.98
| Facility | 50 | $11,748.98 | $11,748.98 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $537.03 / $831.76
| Professional | | $416.87 | $537.03 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $537.03 / $537.03
| Professional | | $537.03 | $537.03 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $7,413.10 / $13,803.84
| Facility | | $2,691.53 | $7,413.10 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $524.81 / $691.83
| Professional | | $489.78 | $524.81 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $1,949.84 / $2,511.89
| Facility | | $371.54 | $1,949.84 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $645.65 / $1,122.02
| Professional | | $478.63 | $645.65 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $630.96 / $1,148.15
| Facility | | $446.68 | $630.96 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $13,182.57 / $23,988.33
| Facility | | $5,128.61 | $13,182.57 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $562.34 / $1,096.48
| Professional | | $407.38 | $562.34 | $1,096.48 |