- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $5,623.41 / $10,471.29
| Facility | | $2,691.53 | $5,623.41 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,570.40 / $5,128.61 / $8,511.38
| Facility | 50 | $2,570.40 | $5,128.61 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $363.08 / $794.33
| Professional | | $162.18 | $363.08 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $676.08 / $676.08 / $707.95
| Professional | 50 | $676.08 | $676.08 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $380.19 / $831.76
| Professional | | $186.21 | $380.19 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $457.09 / $616.60
| Professional | | $338.84 | $457.09 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $7,585.78 / $11,748.98
| Facility | | $4,677.35 | $7,585.78 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $407.38 / $794.33
| Professional | | $181.97 | $407.38 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $6,606.93 / $10,964.78
| Facility | | $2,884.03 | $6,606.93 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $331.13 / $707.95
| Professional | | $173.78 | $331.13 | $707.95 |