- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $5,495.41 / $11,481.54
| Facility | | $1,047.13 | $5,495.41 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,570.40 / $5,128.61 / $6,606.93
| Facility | 50 | $2,570.40 | $5,128.61 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $537.03 / $1,047.13
| Professional | | $398.11 | $537.03 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $281.84 / $870.96 / $2,570.40
| Professional | 50 | $281.84 | $870.96 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $512.86
| Professional | | $512.86 | $512.86 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $1,148.15
| Professional | 50 | $1,148.15 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,023.29 / $1,230.27
| Facility | | $630.96 | $1,023.29 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $524.81 / $1,071.52
| Professional | | $338.84 | $524.81 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $5,888.44 / $11,481.54
| Facility | | $3,235.94 | $5,888.44 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $398.11 / $575.44
| Professional | | $223.87 | $398.11 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $616.60
| Professional | | $32.36 | $33.11 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,623.41 / $9,772.37
| Facility | | $1,698.24 | $5,623.41 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $446.68 / $776.25
| Professional | | $323.59 | $446.68 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $407.38 / $524.81
| Professional | | $331.13 | $407.38 | $524.81 |