- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,522.96 / $2,522.96 / $21,273.60
| Professional | | $2,522.96 | $2,522.96 | $21,273.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,236.52 / $24,536.18 / $48,429.15
| Facility | | $14,236.52 | $24,536.18 | $48,429.15 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $25,084.95 / $38,059.35 / $66,733.70
| Facility | 50 | $25,084.95 | $38,059.35 | $66,733.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $861.50 / $3,412.92 / $10,097.89
| Professional | | $861.50 | $3,412.92 | $10,097.89 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $1,258.58 / $5,119.38 / $15,113.55
| Professional | 50 | $1,258.58 | $5,119.38 | $15,113.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,649.44 / $10,847.86 / $26,095.99
| Facility | | $7,649.44 | $10,847.86 | $26,095.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,013.52 / $3,501.12 / $12,504.07
| Professional | | $1,013.52 | $3,501.12 | $12,504.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,023.18 / $9,917.54 / $20,548.03
| Facility | | $6,023.18 | $9,917.54 | $20,548.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $937.02 / $4,046.53 / $10,863.75
| Professional | | $937.02 | $4,046.53 | $10,863.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $774.52 / $5,967.80 / $29,472.69
| Facility | | $774.52 | $5,967.80 | $29,472.69 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $54,461.09 / $54,461.09 / $54,461.09
| Facility | 50 | $54,461.09 | $54,461.09 | $54,461.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,942.47 / $8,607.14 / $16,865.95
| Professional | | $3,942.47 | $8,607.14 | $16,865.95 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $3,539.17 / $3,539.17 / $17,883.45
| Professional | 50 | $3,539.17 | $3,539.17 | $17,883.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,303.60 / $9,616.39 / $16,104.25
| Professional | | $4,303.60 | $9,616.39 | $16,104.25 |