- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,653.59 / $2,653.59 / $54,937.60
| Professional | | $2,653.59 | $2,653.59 | $54,937.60 |
- 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
- $906.56 / $3,591.42 / $26,557.65
| Professional | | $906.56 | $3,591.42 | $26,557.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,353.77 / $28,879.05 / $69,472.46
| Facility | | $20,353.77 | $28,879.05 | $69,472.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,067.02 / $13,053.23 / $33,057.87
| Professional | | $1,067.02 | $13,053.23 | $33,057.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,034.85 / $26,402.38 / $54,702.73
| Facility | | $16,034.85 | $26,402.38 | $54,702.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $986.49 / $3,173.18 / $28,721.25
| Professional | | $986.49 | $3,173.18 | $28,721.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.40 / $13,749.44 / $29,378.72
| Facility | | $815.40 | $13,749.44 | $29,378.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10,368.78 / $22,111.03 / $43,390.17
| Professional | | $10,368.78 | $22,111.03 | $43,390.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10,527.08 / $22,111.03 / $43,067.52
| Professional | | $10,527.08 | $22,111.03 | $43,067.52 |