- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $4,073.80 / $8,709.64
| Facility | | $562.34 | $4,073.80 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $467.74 / $2,041.74
| Professional | | $234.42 | $467.74 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $2,818.38 / $5,248.07
| Facility | | $1,202.26 | $2,818.38 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,737.80 / $3,715.35 / $7,943.28
| Facility | 50 | $1,737.80 | $3,715.35 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $1,380.38 / $1,698.24
| Professional | | $371.54 | $1,380.38 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $416.87 / $1,621.81
| Professional | | $245.47 | $416.87 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $1,621.81 / $6,165.95
| Facility | | $309.03 | $1,621.81 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $812.83 / $1,737.80
| Professional | | $257.04 | $812.83 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $4,570.88 / $6,456.54
| Facility | | $3,630.78 | $4,570.88 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,495.41 / $7,413.10 / $9,772.37
| Facility | 50 | $5,495.41 | $7,413.10 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $389.05 / $1,513.56
| Professional | | $275.42 | $389.05 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $794.33 / $4,897.79
| Professional | | $380.19 | $794.33 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $12,302.69 / $12,302.69
| Facility | | $5,495.41 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $724.44 / $1,513.56
| Professional | | $239.88 | $724.44 | $1,513.56 |