- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $4,466.84 / $5,495.41
| Facility | | $1,412.54 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $501.19 / $1,148.15
| Professional | | $398.11 | $501.19 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $6,309.57 / $14,454.40
| Facility | | $741.31 | $6,309.57 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,096.48 / $9,120.11 / $25,118.86
| Facility | 50 | $1,096.48 | $9,120.11 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $724.44 / $758.58
| Professional | | $616.60 | $724.44 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $645.65 / $776.25
| Professional | | $512.86 | $645.65 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $794.33 / $5,495.41
| Facility | | $457.09 | $794.33 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $645.65 / $776.25
| Professional | | $562.34 | $645.65 | $776.25 |
- 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
- $9,332.54 / $12,302.69 / $17,782.79
| Facility | | $9,332.54 | $12,302.69 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $13,803.84 / $19,952.62 / $26,915.35
| Facility | 50 | $13,803.84 | $19,952.62 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $758.58 / $794.33
| Professional | | $724.44 | $758.58 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $331.13 / $13,803.84
| Professional | | $309.03 | $331.13 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $17,782.79 / $19,054.61
| Facility | | $11,748.98 | $17,782.79 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $575.44 / $812.83
| Professional | | $426.58 | $575.44 | $812.83 |