- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $7,762.47 / $16,595.87
| Facility | | $1,000.00 | $7,762.47 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,025.60 / $10,471.29 / $28,183.83
| Facility | 50 | $6,025.60 | $10,471.29 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $831.76 / $2,089.30
| Professional | | $575.44 | $831.76 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $13,182.57 / $24,547.09
| Facility | | $3,981.07 | $13,182.57 | $24,547.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $912.01 / $1,698.24
| Professional | | $588.84 | $912.01 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $3,630.78 / $15,135.61
| Facility | | $977.24 | $3,630.78 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $9,332.54 / $10,000.00 / $10,471.29
| Facility | 50 | $9,332.54 | $10,000.00 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $1,000.00 / $2,089.30
| Professional | | $602.56 | $1,000.00 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $8,511.38 / $17,782.79
| Facility | | $2,818.38 | $8,511.38 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $851.14 / $1,548.82
| Professional | | $549.54 | $851.14 | $1,548.82 |