- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $4,365.16 / $7,079.46
| Facility | | $524.81 | $4,365.16 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,238.72 / $2,238.72 / $2,238.72
| Facility | 50 | $2,238.72 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $257.04 / $758.58
| Professional | | $123.03 | $257.04 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $288.40 / $1,096.48 / $2,511.89
| Professional | 50 | $288.40 | $1,096.48 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,162.28 / $10,471.29
| Facility | | $2,137.96 | $3,162.28 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $257.04 / $389.05
| Professional | | $134.90 | $257.04 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $204.17 / $380.19 / $575.44
| Professional | 50 | $204.17 | $380.19 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $549.54 / $1,479.11
| Facility | | $549.54 | $549.54 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $338.84 / $660.69
| Professional | | $186.21 | $338.84 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $457.09 / $575.44
| Professional | | $295.12 | $457.09 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $269.15
| Professional | | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $4,466.84 / $9,332.54
| Facility | | $1,819.70 | $4,466.84 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $275.42 / $630.96
| Professional | | $123.03 | $275.42 | $630.96 |