- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $7,413.10 / $15,848.93
| Facility | | $2,137.96 | $7,413.10 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,698.24 / $7,762.47 / $23,988.33
| Facility | 22 | $1,698.24 | $7,762.47 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,466.84 / $9,120.11 / $21,379.62
| Facility | 50 | $4,466.84 | $9,120.11 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $602.56 / $1,778.28
| Professional | | $398.11 | $602.56 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $6,760.83 / $14,791.08
| Facility | | $3,162.28 | $6,760.83 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $549.54 / $1,023.29
| Professional | | $371.54 | $549.54 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $1,380.38 / $10,964.78
| Facility | | $457.09 | $1,380.38 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | 22 | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $645.65 / $1,348.96
| Professional | | $416.87 | $645.65 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $7,244.36 / $16,218.10
| Facility | | $2,454.71 | $7,244.36 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $537.03 / $954.99
| Professional | | $363.08 | $537.03 | $954.99 |