- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $4,570.88 / $10,232.93
| Facility | | $1,071.52 | $4,570.88 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,951.21 / $5,888.44 / $5,888.44
| Facility | 50 | $2,951.21 | $5,888.44 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $112.20 / $275.42
| Professional | | $57.54 | $112.20 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $371.54 / $416.87 / $2,454.71
| Professional | 50 | $371.54 | $416.87 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $138.04 / $363.08
| Professional | | $67.61 | $138.04 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $128.82 / $177.83
| Professional | | $104.71 | $128.82 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,344.23 / $3,548.13
| Facility | | $1,445.44 | $2,344.23 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $109.65 / $389.05
| Professional | | $47.86 | $109.65 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,630.78 / $7,762.47
| Facility | | $1,862.09 | $3,630.78 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $100.00 / $229.09
| Professional | | $46.77 | $100.00 | $229.09 |