- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.87 / $3,989.77 / $34,538.56
| Facility | | $309.87 | $3,989.77 | $34,538.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.93 / $1,502.19 / $5,326.82
| Professional | | $286.93 | $1,502.19 | $5,326.82 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $796.42 / $2,253.28 / $2,253.28
| Professional | 50 | $796.42 | $2,253.28 | $2,253.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,124.32 / $18,756.97 / $39,095.87
| Facility | | $4,124.32 | $18,756.97 | $39,095.87 |
- 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
- $537.08 / $2,127.71 / $11,313.08
| Professional | | $537.08 | $2,127.71 | $11,313.08 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $784.65 / $3,191.58 / $16,932.32
| Professional | 50 | $784.65 | $3,191.58 | $16,932.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,654.01 / $12,278.79 / $29,538.30
| Facility | | $8,654.01 | $12,278.79 | $29,538.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $644.46 / $5,628.54 / $14,155.74
| Professional | | $644.46 | $5,628.54 | $14,155.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,817.70 / $11,225.76 / $23,258.50
| Facility | | $6,817.70 | $11,225.76 | $23,258.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $595.82 / $3,120.93 / $12,298.75
| Professional | | $595.82 | $3,120.93 | $12,298.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.58 / $6,742.71 / $27,343.83
| Facility | | $490.58 | $6,742.71 | $27,343.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,077.84 / $8,039.91 / $13,768.41
| Professional | | $5,077.84 | $8,039.91 | $13,768.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,028.00 / $11,496.00 / $55,151.00
| Facility | | $5,028.00 | $11,496.00 | $55,151.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,046.03 / $7,516.26 / $13,146.60
| Professional | | $4,046.03 | $7,516.26 | $13,146.60 |