- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $3,019.95 / $10,964.78
| Facility | | $549.54 | $3,019.95 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,162.28 / $3,162.28 / $3,162.28
| Facility | 50 | $3,162.28 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $446.68 / $1,148.15
| Professional | | $234.42 | $446.68 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $645.65 / $794.33 / $1,862.09
| Professional | 50 | $645.65 | $794.33 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $234.42 / $478.63
| Professional | | $199.53 | $234.42 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $316.23 / $316.23 / $316.23
| Professional | 50 | $316.23 | $316.23 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $12,589.25 / $53,703.18
| Facility | | $144.54 | $12,589.25 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $398.11 / $954.99
| Professional | | $169.82 | $398.11 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,884.03 / $6,309.57
| Facility | | $1,905.46 | $2,884.03 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $213.80 / $478.63
| Professional | | $169.82 | $213.80 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $302.00
| Professional | | $32.36 | $33.11 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,570.40 / $5,011.87
| Facility | | $537.03 | $2,570.40 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $467.74 / $812.83
| Professional | | $323.59 | $467.74 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $223.87 / $234.42
| Professional | | $204.17 | $223.87 | $234.42 |