- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,015.00 / $2,747.00 / $4,820.96
| Facility | | $1,015.00 | $2,747.00 | $4,820.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,960.44 / $2,890.85 / $7,419.26
| Facility | 50 | $1,960.44 | $2,890.85 | $7,419.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $451.80 / $587.32 / $1,333.00
| Professional | | $451.80 | $587.32 | $1,333.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,169.64 / $2,826.85 / $9,401.00
| Facility | | $1,169.64 | $2,826.85 | $9,401.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $497.12 / $869.10 / $3,773.76
| Professional | | $497.12 | $869.10 | $3,773.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $624.98 / $1,028.08 / $1,388.39
| Professional | | $624.98 | $1,028.08 | $1,388.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.05 / $818.80 / $1,469.64
| Professional | | $524.05 | $818.80 | $1,469.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.50 / $1,139.59 / $6,679.00
| Facility | | $524.50 | $1,139.59 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $601.86 / $729.06 / $1,002.85
| Professional | | $601.86 | $729.06 | $1,002.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $649.22 / $1,287.01 / $1,697.78
| Professional | | $649.22 | $1,287.01 | $1,697.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,449.74 / $2,479.02 / $5,421.38
| Facility | | $1,449.74 | $2,479.02 | $5,421.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.62 / $931.30 / $1,232.45
| Professional | | $450.62 | $931.30 | $1,232.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,943.56 / $5,268.00 / $26,542.00
| Facility | | $1,943.56 | $5,268.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $530.16 / $960.44 / $3,773.76
| Professional | | $530.16 | $960.44 | $3,773.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.32 / $786.43 / $1,669.85
| Professional | | $524.32 | $786.43 | $1,669.85 |