- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,239.98 / $3,750.65 / $11,253.48
| Facility | | $1,239.98 | $3,750.65 | $11,253.48 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,697.30 / $7,936.31 / $17,709.68
| Facility | 50 | $6,697.30 | $7,936.31 | $17,709.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.34 / $662.54 / $1,094.09
| Professional | | $468.34 | $662.54 | $1,094.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,006.37 / $1,006.37 / $1,009.20
| Facility | | $1,006.37 | $1,006.37 | $1,009.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $571.52 / $752.37 / $893.44
| Professional | | $571.52 | $752.37 | $893.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.90 / $968.17 / $1,222.69
| Facility | | $480.90 | $968.17 | $1,222.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $845.94 / $922.84 / $1,202.57
| Professional | | $845.94 | $922.84 | $1,202.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $817.32 / $910.73
| Professional | | $32.34 | $817.32 | $910.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,897.28 / $3,916.24 / $5,062.58
| Facility | | $2,897.28 | $3,916.24 | $5,062.58 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,051.74 / $5,874.36 / $8,358.86
| Facility | 50 | $4,051.74 | $5,874.36 | $8,358.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $835.32 / $1,045.07 / $1,202.57
| Professional | | $835.32 | $1,045.07 | $1,202.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $9,360.00 / $17,870.00
| Facility | | $1,500.00 | $9,360.00 | $17,870.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $538.91 / $760.91 / $1,043.00
| Professional | | $538.91 | $760.91 | $1,043.00 |