- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,070.51 / $6,408.55 / $16,762.57
| Facility | | $3,070.51 | $6,408.55 | $16,762.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,836.01 / $7,836.01 / $7,836.01
| Facility | 50 | $7,836.01 | $7,836.01 | $7,836.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.88 / $583.66 / $1,732.88
| Professional | | $290.88 | $583.66 | $1,732.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $560.44 / $560.44 / $580.05
| Professional | | $560.44 | $560.44 | $580.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,725.11 / $8,845.35 / $17,109.75
| Facility | | $6,725.11 | $8,845.35 | $17,109.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $306.19 / $577.15 / $904.20
| Professional | | $306.19 | $577.15 | $904.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $601.96 / $1,017.81 / $1,565.29
| Professional | | $601.96 | $1,017.81 | $1,565.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $370.87 / $785.72 / $5,341.00
| Facility | | $370.87 | $785.72 | $5,341.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $620.58 / $1,159.72 / $4,387.22
| Professional | | $620.58 | $1,159.72 | $4,387.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $419.80 / $893.61 / $1,565.29
| Facility | | $419.80 | $893.61 | $1,565.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $785.84 / $1,190.23 / $1,729.53
| Professional | | $785.84 | $1,190.23 | $1,729.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $620.58 / $1,112.75 / $1,614.44
| Professional | | $620.58 | $1,112.75 | $1,614.44 |