- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $9,120.11 / $18,197.01
| Facility | | $676.08 | $9,120.11 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $562.34 / $1,023.29
| Professional | | $416.87 | $562.34 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $281.84 / $870.96 / $1,584.89
| Professional | 50 | $281.84 | $870.96 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $645.65
| Professional | | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $977.24 / $977.24 / $977.24
| Professional | 50 | $977.24 | $977.24 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $4,365.16 / $7,943.28
| Facility | | $2,041.74 | $4,365.16 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $549.54 / $794.33
| Professional | | $380.19 | $549.54 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $1,659.59
| Facility | | $707.95 | $707.95 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $562.34 / $1,023.29
| Professional | | $389.05 | $562.34 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $616.60 / $1,202.26
| Facility | | $446.68 | $616.60 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $10,964.78 / $16,982.44
| Facility | | $1,995.26 | $10,964.78 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $489.78 / $741.31
| Professional | | $371.54 | $489.78 | $741.31 |