- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,711.51 / $13,200.00
| Facility | | $1,000.00 | $3,711.51 | $13,200.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,151.00 / $4,435.78 / $9,580.50
| Facility | 50 | $2,151.00 | $4,435.78 | $9,580.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.86 / $388.04 / $488.31
| Professional | | $272.86 | $388.04 | $488.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,599.13 / $11,846.28 / $18,641.72
| Facility | | $7,599.13 | $11,846.28 | $18,641.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.51 / $516.91 / $567.59
| Professional | | $291.51 | $516.91 | $567.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.14 / $375.75 / $540.78
| Professional | | $274.14 | $375.75 | $540.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.86 / $509.72 / $5,558.80
| Facility | | $272.86 | $509.72 | $5,558.80 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,180.00 / $10,180.00 / $10,180.00
| Facility | 50 | $10,180.00 | $10,180.00 | $10,180.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.92 / $562.52 / $4,486.05
| Professional | | $304.92 | $562.52 | $4,486.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.00 / $3,317.00 / $5,543.93
| Facility | | $884.00 | $3,317.00 | $5,543.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.52 / $411.07 / $780.18
| Professional | | $286.52 | $411.07 | $780.18 |