- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.91 / $4,518.60 / $13,841.56
| Facility | | $350.91 | $4,518.60 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,794.74 / $3,491.64 / $7,482.74
| Facility | 50 | $1,794.74 | $3,491.64 | $7,482.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.50 / $350.91 / $1,173.24
| Professional | | $205.50 | $350.91 | $1,173.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,604.20 / $6,007.32 / $11,713.83
| Facility | | $4,604.20 | $6,007.32 | $11,713.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.33 / $417.55 / $702.87
| Professional | | $218.33 | $417.55 | $702.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,539.00 / $1,539.00 / $1,539.00
| Facility | | $1,539.00 | $1,539.00 | $1,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $492.28 / $699.41 / $1,074.18
| Professional | | $492.28 | $699.41 | $1,074.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.60 / $593.20 / $4,217.00
| Facility | | $246.60 | $593.20 | $4,217.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,369.07 / $4,369.07 / $4,369.07
| Facility | 50 | $4,369.07 | $4,369.07 | $4,369.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.03 / $786.94 / $1,209.38
| Professional | | $549.03 | $786.94 | $1,209.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $481.79 / $904.01 / $1,908.09
| Facility | | $481.79 | $904.01 | $1,908.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $462.79 / $745.00 / $1,049.14
| Professional | | $462.79 | $745.00 | $1,049.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $582.34 / $843.59 / $1,024.85
| Professional | | $582.34 | $843.59 | $1,024.85 |