- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $3,715.35 / $6,606.93
| Facility | | $758.58 | $3,715.35 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $416.87 / $933.25
| Professional | | $331.13 | $416.87 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $6,606.93 / $15,848.93
| Facility | | $3,311.31 | $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
- $524.81 / $776.25 / $1,258.93
| Professional | | $524.81 | $776.25 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,258.93 / $2,951.21
| Facility | | $891.25 | $1,258.93 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $724.44 / $724.44 / $724.44
| Facility | 22 | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $1,071.52 / $1,621.81
| Professional | | $707.95 | $1,071.52 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,202.26 / $2,344.23
| Facility | | $954.99 | $1,202.26 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $912.01 / $1,348.96
| Professional | | $645.65 | $912.01 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $2,137.96 / $7,762.47
| Facility | | $501.19 | $2,137.96 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,454.71 / $3,890.45 / $4,466.84
| Facility | 50 | $2,454.71 | $3,890.45 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $724.44 / $1,548.82
| Professional | | $436.52 | $724.44 | $1,548.82 |
- 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
- $416.87 / $724.44 / $1,380.38
| Professional | | $416.87 | $724.44 | $1,380.38 |