- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $3,801.89 / $7,762.47
| Facility | | $2,041.74 | $3,801.89 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.37 / $2,818.38 / $3,981.07
| Facility | 50 | $0.37 | $2,818.38 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $537.03 / $1,380.38
| Professional | | $302.00 | $537.03 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $245.47 / $2,137.96 / $2,137.96
| Professional | 50 | $245.47 | $2,137.96 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $331.13 / $457.09
| Professional | | $69.18 | $331.13 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,089.30 / $3,090.30
| Facility | | $630.96 | $2,089.30 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $602.56 / $1,584.89
| Professional | | $416.87 | $602.56 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $380.19 / $380.19
| Facility | | $380.19 | $380.19 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $489.78 / $977.24
| Professional | | $302.00 | $489.78 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $645.65 / $6,165.95
| Facility | | $302.00 | $645.65 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $630.96 / $3,630.78
| Professional | | $416.87 | $630.96 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $4,073.80 / $7,244.36
| Facility | | $2,691.53 | $4,073.80 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $467.74 / $741.31
| Professional | | $281.84 | $467.74 | $741.31 |