- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $4,677.35 / $8,912.51
| Facility | | $1,949.84 | $4,677.35 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,691.53 / $2,691.53 / $2,691.53
| Facility | 22 | $2,691.53 | $2,691.53 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,630.27 / $6,606.93 / $21,379.62
| Facility | 50 | $2,630.27 | $6,606.93 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $794.33 / $2,137.96
| Professional | | $489.78 | $794.33 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $5,248.07 / $33,884.42
| Facility | | $1,174.90 | $5,248.07 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $954.99 / $954.99 / $954.99
| Facility | AS | $954.99 | $954.99 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $741.31 / $4,168.69
| Professional | | $501.19 | $741.31 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $812.83 / $1,047.13 / $1,445.44
| Professional | | $812.83 | $1,047.13 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $912.01 / $3,715.35
| Facility | | $831.76 | $912.01 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $691.83 / $1,445.44
| Professional | | $338.84 | $691.83 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $1,096.48 / $7,079.46
| Facility | | $512.86 | $1,096.48 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $741.31 / $1,071.52
| Professional | | $537.03 | $741.31 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $4,570.88 / $11,220.18
| Facility | | $645.65 | $4,570.88 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $933.25 / $1,445.44
| Professional | | $524.81 | $933.25 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $5,248.07 / $7,585.78
| Facility | | $1,412.54 | $5,248.07 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $831.76 / $1,348.96
| Professional | | $524.81 | $831.76 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $5,248.07 / $33,884.42
| Facility | | $1,174.90 | $5,248.07 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $954.99 / $954.99 / $954.99
| Facility | AS | $954.99 | $954.99 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $741.31 / $4,168.69
| Professional | | $501.19 | $741.31 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $4,786.30 / $10,232.93
| Facility | | $1,479.11 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $741.31 / $1,513.56
| Professional | | $501.19 | $741.31 | $1,513.56 |