- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $6,025.60 / $12,882.50
| Facility | | $1,071.52 | $6,025.60 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $10,715.19 / $10,715.19 / $10,715.19
| Facility | 50 | $10,715.19 | $10,715.19 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $707.95 / $1,862.09
| Professional | | $501.19 | $707.95 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $3,235.94 / $3,235.94
| Facility | | $3,235.94 | $3,235.94 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $562.34 / $977.24
| Professional | | $446.68 | $562.34 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $4,265.80 / $18,197.01
| Facility | | $2,454.71 | $4,265.80 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,467.37 / $3,467.37 / $19,952.62
| Facility | 50 | $3,467.37 | $3,467.37 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $549.54 / $549.54
| Professional | | $549.54 | $549.54 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,258.93 / $2,187.76
| Facility | | $1,258.93 | $1,258.93 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $524.81 / $794.33
| Professional | | $426.58 | $524.81 | $794.33 |