- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,981.07 / $6,918.31
| Facility | | $1,023.29 | $3,981.07 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,897.79 / $6,025.60 / $6,309.57
| Facility | 50 | $4,897.79 | $6,025.60 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $870.96 / $3,019.95
| Professional | | $575.44 | $870.96 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $7,413.10 / $16,218.10
| Facility | | $1,380.38 | $7,413.10 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $977.24 / $2,238.72
| Professional | | $562.34 | $977.24 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $660.69 / $1,513.56
| Facility | | $660.69 | $660.69 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $1,174.90 / $2,511.89
| Professional | | $707.95 | $1,174.90 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,819.70 / $8,511.38
| Facility | | $524.81 | $1,819.70 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $891.25 / $1,318.26
| Professional | | $467.74 | $891.25 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $6,918.31 / $15,488.17
| Facility | | $2,570.40 | $6,918.31 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $1,071.52 / $1,995.26
| Professional | | $630.96 | $1,071.52 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $6,165.95 / $9,549.93
| Facility | | $3,890.45 | $6,165.95 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,380.38 / $1,380.38
| Professional | | $1,380.38 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $8,128.31 / $16,218.10
| Facility | | $1,380.38 | $8,128.31 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $977.24 / $2,187.76
| Professional | | $562.34 | $977.24 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $6,456.54 / $14,125.38
| Facility | | $2,570.40 | $6,456.54 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $1,122.02 / $2,187.76
| Professional | | $645.65 | $1,122.02 | $2,187.76 |