- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.53 / $5,387.55 / $9,836.73
| Facility | | $416.53 | $5,387.55 | $9,836.73 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,702.22 / $13,643.20 / $15,015.68
| Facility | 50 | $7,702.22 | $13,643.20 | $15,015.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.11 / $350.03 / $921.72
| Professional | | $156.11 | $350.03 | $921.72 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $108.25 / $475.93 / $629.57
| Professional | 50 | $108.25 | $475.93 | $629.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.75 / $296.23 / $817.01
| Professional | | $216.75 | $296.23 | $817.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $187.91 / $448.04 / $1,050.21
| Facility | | $187.91 | $448.04 | $1,050.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $247.65 / $406.11 / $725.20
| Professional | | $247.65 | $406.11 | $725.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $515.50 / $648.53
| Professional | | $32.34 | $515.50 | $648.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,399.76 / $8,522.07 / $10,689.08
| Facility | | $5,399.76 | $8,522.07 | $10,689.08 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,345.97 / $12,783.11 / $16,471.71
| Facility | 50 | $7,345.97 | $12,783.11 | $16,471.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.29 / $288.87 / $748.85
| Professional | | $235.29 | $288.87 | $748.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,550.00 / $12,152.00 / $12,233.00
| Facility | | $5,550.00 | $12,152.00 | $12,233.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.00 / $708.96 / $958.30
| Professional | | $440.00 | $708.96 | $958.30 |