- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,098.00 / $5,094.39 / $12,036.14
| Facility | | $1,098.00 | $5,094.39 | $12,036.14 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,970.01 / $6,970.01 / $6,970.01
| Facility | 50 | $6,970.01 | $6,970.01 | $6,970.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.91 / $577.95 / $1,155.91
| Professional | | $379.91 | $577.95 | $1,155.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.82 / $896.52 / $896.52
| Professional | | $380.82 | $896.52 | $896.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,904.89 / $9,357.90 / $17,567.16
| Facility | | $6,904.89 | $9,357.90 | $17,567.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.68 / $702.37 / $983.13
| Professional | | $400.68 | $702.37 | $983.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $920.66 / $1,181.89 / $1,487.45
| Professional | | $920.66 | $1,181.89 | $1,487.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $483.87 / $822.58 / $4,766.80
| Facility | | $483.87 | $822.58 | $4,766.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $635.69 / $1,178.48 / $3,896.24
| Professional | | $635.69 | $1,178.48 | $3,896.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $920.66 / $1,178.48 / $2,691.59
| Facility | | $920.66 | $1,178.48 | $2,691.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $800.98 / $1,054.20 / $1,422.53
| Professional | | $800.98 | $1,054.20 | $1,422.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $534.16 / $721.21 / $949.00
| Professional | | $534.16 | $721.21 | $949.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $635.69 / $1,139.54 / $1,369.17
| Professional | | $635.69 | $1,139.54 | $1,369.17 |