- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,586.28 / $6,141.01 / $17,900.75
| Facility | | $1,586.28 | $6,141.01 | $17,900.75 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,615.00 / $2,932.49 / $7,344.08
| Facility | 50 | $1,615.00 | $2,932.49 | $7,344.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.44 / $243.50 / $672.06
| Professional | | $181.44 | $243.50 | $672.06 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $360.12 / $544.32 / $1,972.50
| Professional | 50 | $360.12 | $544.32 | $1,972.50 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $160.04 / $160.04 / $160.04
| Professional | 50 | $160.04 | $160.04 | $160.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,232.51 / $1,670.37 / $3,135.72
| Facility | | $1,232.51 | $1,670.37 | $3,135.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.97 / $398.81 / $531.75
| Professional | | $233.97 | $398.81 | $531.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.56 / $605.90 / $800.40
| Professional | | $487.56 | $605.90 | $800.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $310.45 / $673.41 / $8,617.27
| Facility | | $310.45 | $673.41 | $8,617.27 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.62 / $2,419.50 / $10,472.50
| Facility | 50 | $0.62 | $2,419.50 | $10,472.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.91 / $620.86 / $5,305.00
| Professional | | $350.91 | $620.86 | $5,305.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $487.56 / $708.59 / $4,487.09
| Facility | | $487.56 | $708.59 | $4,487.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $482.91 / $611.97 / $800.40
| Professional | | $482.91 | $611.97 | $800.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $558.79 / $677.60
| Professional | | $5.00 | $558.79 | $677.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.91 / $589.83 / $728.76
| Professional | | $350.91 | $589.83 | $728.76 |