- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $4,265.80 / $8,511.38
| Facility | | $1,148.15 | $4,265.80 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,023.29 / $3,467.37 / $4,897.79
| Facility | 50 | $1,023.29 | $3,467.37 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $426.58 / $1,819.70
| Professional | | $208.93 | $426.58 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $229.09 / $616.60 / $2,754.23
| Professional | 50 | $229.09 | $616.60 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $81,283.05 / $95,499.26
| Facility | | $46,773.51 | $81,283.05 | $95,499.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $331.13 / $691.83
| Professional | | $302.00 | $331.13 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $302.00 / $302.00
| Facility | | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $371.54 / $676.08
| Professional | | $251.19 | $371.54 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $691.83 / $794.33
| Facility | | $331.13 | $691.83 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $691.83 / $794.33
| Professional | | $331.13 | $691.83 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $426.58 / $812.83
| Facility | | $186.21 | $426.58 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $371.54 / $912.01
| Professional | | $79.43 | $371.54 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $457.09 / $758.58
| Professional | | $331.13 | $457.09 | $758.58 |