- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,467.37 / $10,232.93
| Facility | | $1,047.13 | $3,467.37 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $16,982.44 / $16,982.44 / $16,982.44
| Facility | 50 | $16,982.44 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $446.68 / $1,122.02
| Professional | | $380.19 | $446.68 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $446.68 / $831.76
| Professional | | $363.08 | $446.68 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $489.78 / $537.03
| Facility | | $489.78 | $489.78 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,071.52 / $1,071.52
| Professional | | $1,071.52 | $1,071.52 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $660.69 / $933.25
| Professional | | $398.11 | $660.69 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $4,168.69 / $10,715.19
| Facility | | $977.24 | $4,168.69 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $562.34 / $1,023.29
| Professional | | $389.05 | $562.34 | $1,023.29 |