- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $4,570.88 / $11,748.98
| Facility | | $831.76 | $4,570.88 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,715.35 / $8,709.64 / $19,054.61
| Facility | 50 | $3,715.35 | $8,709.64 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $1,230.27 / $3,311.31
| Professional | | $309.03 | $1,230.27 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $549.54 / $1,348.96 / $9,120.11
| Professional | 50 | $549.54 | $1,348.96 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $7,079.46 / $15,135.61
| Facility | | $2,754.23 | $7,079.46 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $1,148.15 / $3,388.44
| Professional | | $331.13 | $1,148.15 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $489.78 / $1,737.80 / $4,677.35
| Professional | 50 | $489.78 | $1,737.80 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $3,311.31 / $9,549.93
| Facility | | $467.74 | $3,311.31 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $1,096.48 / $3,388.44
| Professional | | $338.84 | $1,096.48 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $5,623.41 / $12,302.69
| Facility | | $1,995.26 | $5,623.41 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $1,122.02 / $2,951.21
| Professional | | $302.00 | $1,122.02 | $2,951.21 |