- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $602.56 / $645.65
| Facility | | $245.47 | $602.56 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $537.03 / $891.25
| Professional | | $251.19 | $537.03 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $6,606.93 / $15,848.93
| Facility | | $2,630.27 | $6,606.93 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,128.31 / $14,454.40 / $37,153.52
| Facility | 50 | $8,128.31 | $14,454.40 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $912.01 / $1,905.46
| Professional | | $446.68 | $912.01 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,238.72 / $5,370.32
| Facility | | $1,548.82 | $2,238.72 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $1,202.26 / $2,454.71
| Professional | | $588.84 | $1,202.26 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,137.96 / $4,265.80
| Facility | | $1,737.80 | $2,137.96 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $1,000.00 / $2,187.76
| Professional | | $562.34 | $1,000.00 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $912.01 / $7,762.47
| Facility | | $346.74 | $912.01 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $1,380.38 / $2,511.89
| Professional | | $660.69 | $1,380.38 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,248.07 / $9,120.11
| Facility | | $2,884.03 | $5,248.07 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $831.76 / $1,949.84
| Professional | | $371.54 | $831.76 | $1,949.84 |