- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $3,388.44 / $5,370.32
| Facility | | $1,949.84 | $3,388.44 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $1,348.96 / $5,754.40
| Professional | | $229.09 | $1,348.96 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $416.87 / $11,481.54 / $14,791.08
| Professional | 50 | $416.87 | $11,481.54 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $4,265.80 / $15,135.61
| Facility | | $56.23 | $4,265.80 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $2,570.40 / $9,120.11
| Professional | | $275.42 | $2,570.40 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $691.83
| Facility | | $295.12 | $295.12 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $6,309.57
| Professional | | $501.19 | $501.19 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $1,148.15 / $9,772.37
| Professional | | $331.13 | $1,148.15 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $338.84 / $7,079.46
| Facility | | $177.83 | $338.84 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,548.13 / $4,466.84 / $8,511.38
| Professional | | $3,548.13 | $4,466.84 | $8,511.38 |
- 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
- $263.03 / $3,019.95 / $7,762.47
| Professional | | $263.03 | $3,019.95 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $4,265.80 / $15,135.61
| Facility | | $56.23 | $4,265.80 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $2,570.40 / $8,912.51
| Professional | | $275.42 | $2,570.40 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $12,882.50
| Facility | | $2,137.96 | $5,248.07 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $3,235.94 / $8,128.31
| Professional | | $316.23 | $3,235.94 | $8,128.31 |