- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $5,463.36 / $13,841.56
| Facility | | $1,506.15 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,078.00 / $3,262.68 / $5,600.69
| Facility | 50 | $3,078.00 | $3,262.68 | $5,600.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.56 / $497.64 / $2,147.00
| Professional | | $91.56 | $497.64 | $2,147.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $137.34 / $319.87 / $709.32
| Professional | 50 | $137.34 | $319.87 | $709.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,896.99 / $5,281.43 / $9,914.59
| Facility | | $3,896.99 | $5,281.43 | $9,914.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.12 / $218.47 / $1,107.47
| Professional | | $96.12 | $218.47 | $1,107.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.49 / $1,090.98 / $1,479.60
| Professional | | $220.49 | $1,090.98 | $1,479.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.74 / $813.04 / $2,550.04
| Facility | | $116.74 | $813.04 | $2,550.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $713.38 / $1,188.97 / $2,179.77
| Professional | | $713.38 | $1,188.97 | $2,179.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $237.22 / $1,177.94 / $1,813.25
| Facility | | $237.22 | $1,177.94 | $1,813.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.98 / $868.12 / $1,502.98
| Professional | | $213.98 | $868.12 | $1,502.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $128.90 / $1,720.30
| Professional | | $6.00 | $128.90 | $1,720.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.00 / $3,227.00 / $6,169.00
| Facility | | $1,775.00 | $3,227.00 | $6,169.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $739.80 / $1,231.45 / $1,456.81
| Professional | | $739.80 | $1,231.45 | $1,456.81 |