- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $7,079.46 / $13,182.57
| Facility | | $1,047.13 | $7,079.46 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,202.26 / $1,202.26 / $1,202.26
| Facility | 50 | $1,202.26 | $1,202.26 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $676.08 / $2,238.72
| Professional | | $467.74 | $676.08 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $575.44 / $1,122.02
| Professional | | $416.87 | $575.44 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $9,772.37 / $19,952.62
| Facility | | $7,762.47 | $9,772.37 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $794.33 / $1,122.02
| Professional | | $457.09 | $794.33 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $870.96 / $1,513.56
| Professional | | $380.19 | $870.96 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $831.76 / $6,918.31
| Facility | | $467.74 | $831.76 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $912.01 / $912.01 / $912.01
| Facility | AS | $912.01 | $912.01 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $1,023.29 / $4,073.80
| Professional | | $588.84 | $1,023.29 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.24 / $1,174.90 / $1,621.81
| Professional | | $977.24 | $1,174.90 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $1,122.02 / $1,621.81
| Professional | | $870.96 | $1,122.02 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $6,025.60 / $7,079.46
| Facility | | $6,025.60 | $6,025.60 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $724.44 / $1,318.26
| Professional | | $3.98 | $724.44 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $5,495.41 / $8,912.51
| Facility | | $4,466.84 | $5,495.41 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $776.25 / $1,348.96
| Professional | | $575.44 | $776.25 | $1,348.96 |