- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,042.50 / $4,778.89 / $13,841.56
| Facility | | $2,042.50 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,739.12 / $8,907.65 / $8,907.65
| Facility | 50 | $3,739.12 | $8,907.65 | $8,907.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.55 / $491.12 / $600.52
| Professional | | $153.55 | $491.12 | $600.52 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $230.33 / $230.33 / $1,890.48
| Professional | 50 | $230.33 | $230.33 | $1,890.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,503.12 / $7,458.15 / $14,000.85
| Facility | | $5,503.12 | $7,458.15 | $14,000.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.21 / $307.73 / $471.58
| Professional | | $162.21 | $307.73 | $471.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.08 / $558.95 / $738.20
| Professional | | $366.08 | $558.95 | $738.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $195.78 / $395.69 / $2,872.87
| Facility | | $195.78 | $395.69 | $2,872.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.01 / $578.58 / $2,210.82
| Professional | | $327.01 | $578.58 | $2,210.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.08 / $572.91 / $1,416.99
| Facility | | $366.08 | $572.91 | $1,416.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.08 / $508.42 / $671.19
| Professional | | $366.08 | $508.42 | $671.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $411.30 / $756.30
| Professional | | $5.00 | $411.30 | $756.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.01 / $549.66 / $654.02
| Professional | | $327.01 | $549.66 | $654.02 |