- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $2,884.03 / $4,570.88
| Facility | | $1,122.02 | $2,884.03 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,513.56 / $1,513.56 / $1,513.56
| Facility | 50 | $1,513.56 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $489.78 / $1,288.25
| Professional | | $120.23 | $489.78 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $562.34 / $912.01
| Professional | | $154.88 | $562.34 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $1,122.02
| Professional | | $32.36 | $33.11 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,754.23 / $6,309.57
| Facility | | $2,344.23 | $2,754.23 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,467.37 / $4,073.80 / $9,549.93
| Facility | 50 | $3,467.37 | $4,073.80 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $660.69 / $1,288.25
| Professional | | $177.83 | $660.69 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $467.74 / $1,318.26
| Professional | | $131.83 | $467.74 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $660.69 / $1,047.13
| Professional | | $169.82 | $660.69 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $4,466.84 / $5,128.61
| Facility | | $1,698.24 | $4,466.84 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $269.15 / $933.25
| Professional | | $128.82 | $269.15 | $933.25 |