- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $4,778.89 / $13,841.56
| Facility | | $1,653.00 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,477.47 / $3,477.47 / $3,477.47
| Facility | 50 | $3,477.47 | $3,477.47 | $3,477.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.34 / $218.67 / $565.00
| Professional | | $109.34 | $218.67 | $565.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $246.01 / $246.01 / $246.01
| Professional | 50 | $246.01 | $246.01 | $246.01 |
- 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
- $144.18 / $280.69 / $542.25
| Professional | | $144.18 | $280.69 | $542.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.68 / $534.17 / $766.93
| Professional | | $332.68 | $534.17 | $766.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.15 / $341.41 / $2,872.87
| Facility | | $174.15 | $341.41 | $2,872.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.96 / $637.13 / $1,102.32
| Professional | | $354.96 | $637.13 | $1,102.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $317.14 / $450.76 / $766.93
| Facility | | $317.14 | $450.76 | $766.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.33 / $503.02 / $758.62
| Professional | | $325.33 | $503.02 | $758.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $391.70 / $766.30
| Professional | | $6.00 | $391.70 | $766.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,146.67 / $2,930.31 / $7,772.00
| Facility | | $2,146.67 | $2,930.31 | $7,772.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.11 / $599.58 / $709.50
| Professional | | $360.11 | $599.58 | $709.50 |