- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,162.28 / $6,760.83
| Facility | | $1,348.96 | $3,162.28 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $7,413.10 / $7,413.10 / $7,413.10
| Facility | 50 | $7,413.10 | $7,413.10 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $478.63 / $1,862.09
| Professional | | $346.74 | $478.63 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $316.23 / $354.81
| Professional | | $275.42 | $316.23 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $6,025.60 / $7,762.47
| Facility | | $3,715.35 | $6,025.60 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $467.74 / $741.31
| Professional | | $363.08 | $467.74 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $407.38 / $630.96
| Professional | | $338.84 | $407.38 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $416.87 / $2,691.53
| Professional | | $275.42 | $416.87 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $1,819.70 / $1,819.70
| Facility | | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $457.09 / $2,691.53
| Professional | | $457.09 | $457.09 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $309.03 / $338.84
| Professional | | $309.03 | $309.03 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $2,344.23 / $7,244.36
| Facility | | $1,288.25 | $2,344.23 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $436.52 / $616.60
| Professional | | $346.74 | $436.52 | $616.60 |