- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $3,548.13 / $10,232.93
| Facility | | $645.65 | $3,548.13 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,949.84 / $6,918.31 / $19,054.61
| Facility | 50 | $1,949.84 | $6,918.31 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $1,071.52 / $2,691.53
| Professional | | $302.00 | $1,071.52 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $346.74 / $912.01 / $4,073.80
| Professional | 50 | $346.74 | $912.01 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $7,943.28 / $16,982.44
| Facility | | $3,235.94 | $7,943.28 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $1,412.54 / $3,235.94
| Professional | | $331.13 | $1,412.54 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $478.63 / $2,089.30 / $4,466.84
| Professional | 50 | $478.63 | $2,089.30 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $2,137.96 / $12,302.69
| Facility | | $323.59 | $2,137.96 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $1,202.26 / $3,548.13
| Professional | | $354.81 | $1,202.26 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $8,511.38 / $18,197.01
| Facility | | $2,818.38 | $8,511.38 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $1,318.26 / $2,951.21
| Professional | | $331.13 | $1,318.26 | $2,951.21 |