- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $4,677.35 / $10,471.29
| Facility | | $954.99 | $4,677.35 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,238.72 / $3,715.35 / $6,165.95
| Facility | 50 | $2,238.72 | $3,715.35 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $288.40 / $691.83
| Professional | | $165.96 | $288.40 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $331.13 / $1,000.00 / $1,584.89
| Professional | 50 | $331.13 | $1,000.00 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $4,168.69 / $10,964.78
| Facility | | $3,548.13 | $4,168.69 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $363.08 / $616.60
| Professional | | $186.21 | $363.08 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $281.84 / $537.03 / $933.25
| Professional | 50 | $281.84 | $537.03 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $389.05 / $645.65
| Professional | | $229.09 | $389.05 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $537.03 / $537.03
| Professional | | $489.78 | $537.03 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,202.26 / $1,584.89
| Facility | | $1,202.26 | $1,202.26 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $446.68 / $660.69
| Professional | | $316.23 | $446.68 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $6,025.60 / $9,332.54
| Facility | | $3,388.44 | $6,025.60 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $309.03 / $588.84
| Professional | | $173.78 | $309.03 | $588.84 |