- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $896.30 / $2,663.12 / $4,806.64
| Facility | | $896.30 | $2,663.12 | $4,806.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,012.00 / $3,060.00 / $3,121.50
| Facility | 50 | $1,012.00 | $3,060.00 | $3,121.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.44 / $715.45 / $1,364.12
| Professional | | $311.44 | $715.45 | $1,364.12 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $975.33 / $4,653.00 / $6,996.47
| Professional | 50 | $975.33 | $4,653.00 | $6,996.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $703.72 / $5,097.00 / $20,990.91
| Facility | | $703.72 | $5,097.00 | $20,990.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.05 / $1,211.13 / $5,235.60
| Professional | | $383.05 | $1,211.13 | $5,235.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $348.39 / $447.68 / $888.39
| Facility | | $348.39 | $447.68 | $888.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $413.29 / $865.43 / $1,989.39
| Professional | | $413.29 | $865.43 | $1,989.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.00 / $635.24 / $6,679.00
| Facility | | $300.00 | $635.24 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $827.20 / $1,009.22 / $1,398.57
| Professional | | $827.20 | $1,009.22 | $1,398.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $409.56 / $876.95 / $2,107.31
| Professional | | $409.56 | $876.95 | $2,107.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,635.12 / $2,723.90 / $13,940.06
| Facility | | $1,635.12 | $2,723.90 | $13,940.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $474.74 / $645.77 / $1,867.55
| Professional | | $474.74 | $645.77 | $1,867.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,067.54 / $5,904.00 / $26,542.00
| Facility | | $2,067.54 | $5,904.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $925.04 / $2,018.54 / $8,263.84
| Professional | | $925.04 | $2,018.54 | $8,263.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,386.00 / $5,904.00 / $15,421.00
| Facility | | $2,386.00 | $5,904.00 | $15,421.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $882.97 / $1,478.70 / $2,477.34
| Professional | | $882.97 | $1,478.70 | $2,477.34 |