- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,495.41 / $10,964.78
| Facility | | $977.24 | $5,495.41 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $1,202.26 / $3,311.31
| Professional | | $338.84 | $1,202.26 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $5,128.61 / $8,317.64
| Facility | | $2,344.23 | $5,128.61 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,162.28 / $7,585.78 / $12,589.25
| Facility | 50 | $3,162.28 | $7,585.78 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $1,621.81 / $1,995.26
| Professional | | $489.78 | $1,621.81 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $660.69 / $776.25 / $3,019.95
| Professional | 50 | $660.69 | $776.25 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $549.54 / $2,398.83
| Professional | | $380.19 | $549.54 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $2,290.87 / $9,549.93
| Facility | | $446.68 | $2,290.87 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $1,230.27 / $2,570.40
| Professional | | $407.38 | $1,230.27 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $7,244.36 / $10,471.29
| Facility | | $5,623.41 | $7,244.36 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,511.38 / $12,022.64 / $15,488.17
| Facility | 50 | $8,511.38 | $12,022.64 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $512.86 / $2,041.74
| Professional | | $416.87 | $512.86 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $977.24 / $6,918.31
| Professional | | $512.86 | $977.24 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $16,982.44 / $18,197.01
| Facility | | $9,332.54 | $16,982.44 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $1,122.02 / $3,090.30
| Professional | | $323.59 | $1,122.02 | $3,090.30 |