- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,818.38 / $5,495.41
| Facility | | $1,096.48 | $2,818.38 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $691.83 / $2,754.23 / $7,943.28
| Facility | 50 | $691.83 | $2,754.23 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $549.54 / $1,659.59
| Professional | | $331.13 | $549.54 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $5,128.61 / $33,884.42
| Facility | | $831.76 | $5,128.61 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $524.81 / $5,011.87
| Professional | | $269.15 | $524.81 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $645.65 / $1,230.27
| Professional | | $380.19 | $645.65 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $660.69 / $7,079.46
| Facility | | $316.23 | $660.69 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $354.81 / $537.03
| Professional | | $186.21 | $354.81 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $602.56 / $977.24
| Professional | | $338.84 | $602.56 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,466.84 / $6,606.93
| Facility | | $2,344.23 | $4,466.84 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $588.84 / $616.60
| Professional | | $309.03 | $588.84 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $5,370.32 / $33,884.42
| Facility | | $831.76 | $5,370.32 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $524.81 / $5,011.87
| Professional | | $269.15 | $524.81 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $9,772.37
| Facility | | $1,862.09 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $562.34 / $1,288.25
| Professional | | $380.19 | $562.34 | $1,288.25 |