- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $3,388.44 / $9,120.11
| Facility | | $588.84 | $3,388.44 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,862.09 / $2,398.83 / $8,511.38
| Facility | 50 | $1,862.09 | $2,398.83 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $478.63 / $977.24
| Professional | | $363.08 | $478.63 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $5,248.07 / $11,220.18
| Facility | | $2,089.30 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $501.19 / $954.99
| Professional | | $354.81 | $501.19 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $1,412.54 / $3,311.31
| Facility | | $645.65 | $1,412.54 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $575.44 / $1,288.25
| Professional | | $354.81 | $575.44 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $4,168.69 / $9,549.93
| Facility | | $1,445.44 | $4,168.69 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $457.09 / $870.96
| Professional | | $331.13 | $457.09 | $870.96 |