- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $9,120.11 / $15,488.17
| Facility | | $1,862.09 | $9,120.11 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,737.80 / $4,168.69 / $5,495.41
| Facility | 50 | $1,737.80 | $4,168.69 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $645.65 / $1,380.38
| Professional | | $446.68 | $645.65 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $562.34 / $870.96
| Professional | | $295.12 | $562.34 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $5,128.61 / $10,000.00
| Facility | | $2,187.76 | $5,128.61 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $489.78 / $758.58
| Professional | | $416.87 | $489.78 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $870.96 / $2,344.23
| Facility | | $870.96 | $870.96 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $645.65 / $1,148.15
| Professional | | $501.19 | $645.65 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $741.31 / $1,174.90
| Professional | | $741.31 | $741.31 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $660.69 / $1,122.02
| Facility | | $501.19 | $660.69 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $12,589.25 / $23,442.29
| Facility | | $2,344.23 | $12,589.25 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $524.81 / $870.96
| Professional | | $416.87 | $524.81 | $870.96 |