- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $4,570.88 / $8,709.64
| Facility | | $501.19 | $4,570.88 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,412.54 / $1,412.54 / $2,041.74
| Facility | 50 | $1,412.54 | $1,412.54 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $562.34 / $1,174.90
| Professional | | $436.52 | $562.34 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $60.26 / $602.56 / $1,737.80
| Professional | 50 | $60.26 | $602.56 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $645.65 / $891.25
| Professional | | $363.08 | $645.65 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $1,122.02
| Professional | | $32.36 | $33.11 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $3,890.45 / $8,912.51
| Facility | | $3,311.31 | $3,890.45 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,011.87 / $5,888.44 / $13,489.63
| Facility | 50 | $5,011.87 | $5,888.44 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $851.14 / $1,047.13
| Professional | | $602.56 | $851.14 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $831.76 / $1,288.25
| Professional | | $478.63 | $831.76 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $691.83 / $1,348.96
| Professional | | $524.81 | $691.83 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $5,128.61 / $7,079.46
| Facility | | $1,995.26 | $5,128.61 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $478.63 / $741.31
| Professional | | $371.54 | $478.63 | $741.31 |