- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,445.44 / $5,754.40
| Facility | | $707.95 | $1,445.44 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $3,235.94 / $8,511.38
| Professional | | $309.03 | $3,235.94 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $331.13 / $2,754.23
| Professional | | $251.19 | $331.13 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $17,782.79 / $23,988.33
| Facility | | $15,135.61 | $17,782.79 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $22,387.21 / $26,915.35 / $36,307.81
| Facility | 50 | $22,387.21 | $26,915.35 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $2,691.53 / $4,168.69
| Professional | | $257.04 | $2,691.53 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $524.81 / $6,025.60
| Professional | | $309.03 | $524.81 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $6,456.54 / $12,022.64
| Facility | | $2,511.89 | $6,456.54 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $2,290.87 / $4,786.30
| Professional | | $257.04 | $2,290.87 | $4,786.30 |