- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $7,244.36 / $13,489.63
| Facility | | $1,122.02 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,918.31 / $6,918.31 / $10,715.19
| Facility | 50 | $6,918.31 | $6,918.31 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $165.96 / $851.14
| Professional | | $138.04 | $165.96 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $4,677.35 / $9,120.11
| Facility | | $3,548.13 | $4,677.35 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $234.42 / $338.84
| Professional | | $134.90 | $234.42 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $338.84 / $446.68
| Professional | | $151.36 | $338.84 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $316.23 / $7,943.28
| Facility | | $151.36 | $316.23 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $295.12 / $1,122.02
| Professional | | $186.21 | $295.12 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $338.84 / $467.74
| Professional | | $331.13 | $338.84 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $338.84 / $338.84
| Professional | | $338.84 | $338.84 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $223.87 / $398.11
| Professional | | $3.98 | $223.87 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $3,715.35 / $8,128.31
| Facility | | $2,630.27 | $3,715.35 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $288.40 / $389.05
| Professional | | $194.98 | $288.40 | $389.05 |