- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $2,818.38 / $6,025.60
| Facility | | $218.78 | $2,818.38 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,000.00 / $4,677.35 / $7,244.36
| Facility | 50 | $1,000.00 | $4,677.35 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $288.40 / $676.08
| Professional | | $107.15 | $288.40 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $3,467.37 / $8,511.38
| Facility | | $2,454.71 | $3,467.37 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $331.13 / $616.60
| Professional | | $128.82 | $331.13 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $309.03 / $794.33
| Professional | | $141.25 | $309.03 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $457.09 / $831.76
| Professional | | $131.83 | $457.09 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $309.03 / $323.59
| Professional | | $93.33 | $309.03 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $2,290.87 / $3,890.45
| Facility | | $1,258.93 | $2,290.87 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $346.74 / $977.24
| Professional | | $144.54 | $346.74 | $977.24 |