- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.48 / $6,572.70 / $19,525.57
| Facility | | $1,120.48 | $6,572.70 | $19,525.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $410.79 / $562.24 / $1,120.48
| Professional | | $410.79 | $562.24 | $1,120.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $417.72 / $544.01 / $594.53
| Professional | | $417.72 | $544.01 | $594.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,075.42 / $5,251.24 / $9,397.17
| Facility | | $2,075.42 | $5,251.24 | $9,397.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.00 / $467.62 / $740.37
| Professional | | $344.00 | $467.62 | $740.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $1,956.98 / $2,514.75
| Facility | | $505.00 | $1,956.98 | $2,514.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $453.42 / $637.11 / $1,178.55
| Professional | | $453.42 | $637.11 | $1,178.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.79 / $592.52 / $1,010.21
| Facility | | $410.79 | $592.52 | $1,010.21 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $740.39 / $925.91 / $1,405.21
| Facility | 50 | $740.39 | $925.91 | $1,405.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,119.56 / $1,731.45 / $1,899.29
| Professional | | $1,119.56 | $1,731.45 | $1,899.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.48 / $469.94 / $784.80
| Professional | | $71.48 | $469.94 | $784.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.00 / $10,257.00 / $16,249.00
| Facility | | $791.00 | $10,257.00 | $16,249.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $495.81 / $712.68 / $1,248.56
| Professional | | $495.81 | $712.68 | $1,248.56 |