- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $3,630.78 / $6,456.54
| Facility | | $1,412.54 | $3,630.78 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $776.25 / $4,168.69 / $9,120.11
| Facility | 50 | $776.25 | $4,168.69 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $416.87 / $1,584.89
| Professional | | $309.03 | $416.87 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $295.12 / $1,000.00 / $3,162.28
| Professional | 50 | $295.12 | $1,000.00 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $5,248.07 / $13,803.84
| Facility | | $776.25 | $5,248.07 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $575.44 / $6,165.95
| Professional | | $275.42 | $575.44 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $630.96 / $630.96
| Professional | | $630.96 | $630.96 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $645.65 / $1,202.26
| Professional | | $398.11 | $645.65 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $812.83 / $7,079.46
| Facility | | $281.84 | $812.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $389.05 / $741.31
| Professional | | $316.23 | $389.05 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $537.03 / $851.14
| Professional | | $331.13 | $537.03 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $5,495.41 / $14,454.40
| Facility | | $1,380.38 | $5,495.41 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $575.44
| Professional | | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $5,623.41 / $13,803.84
| Facility | | $776.25 | $5,623.41 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $562.34 / $6,165.95
| Professional | | $275.42 | $562.34 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $12,882.50
| Facility | | $2,041.74 | $5,248.07 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $602.56 / $1,023.29
| Professional | | $363.08 | $602.56 | $1,023.29 |