- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $3,090.30 / $9,332.54
| Facility | | $446.68 | $3,090.30 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,905.46 / $2,041.74 / $6,760.83
| Facility | 50 | $1,905.46 | $2,041.74 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $478.63 / $1,047.13
| Professional | | $144.54 | $478.63 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $7,079.46 / $13,803.84
| Facility | | $2,884.03 | $7,079.46 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $501.19 / $1,230.27
| Professional | | $154.88 | $501.19 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,548.82 / $4,365.16
| Facility | | $34.67 | $1,548.82 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $467.74 / $1,288.25
| Professional | | $158.49 | $467.74 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $1,174.90 / $3,630.78
| Facility | | $263.03 | $1,174.90 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $457.09 / $1,122.02
| Professional | | $147.91 | $457.09 | $1,122.02 |