- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $2,570.40 / $4,897.79
| Facility | | $354.81 | $2,570.40 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $562.34 / $1,905.46 / $7,079.46
| Facility | 50 | $562.34 | $1,905.46 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $354.81 / $851.14
| Professional | | $169.82 | $354.81 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $138.04 / $630.96 / $2,511.89
| Professional | 50 | $138.04 | $630.96 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $5,011.87 / $28,840.32
| Facility | | $436.52 | $5,011.87 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $389.05 / $891.25
| Professional | | $190.55 | $389.05 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $208.93 / $467.74
| Facility | | $208.93 | $208.93 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $616.60
| Professional | | $354.81 | $354.81 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $478.63 / $891.25
| Professional | | $234.42 | $478.63 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $501.19 / $7,079.46
| Facility | | $158.49 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $436.52 / $812.83
| Professional | | $346.74 | $436.52 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $354.81 / $758.58
| Professional | | $186.21 | $354.81 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,454.71 / $5,495.41
| Facility | | $575.44 | $2,454.71 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $812.83
| Professional | | $269.15 | $269.15 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $398.11 / $398.11 / $398.11
| Professional | 50 | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $5,011.87 / $28,840.32
| Facility | | $436.52 | $5,011.87 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $389.05 / $891.25
| Professional | | $190.55 | $389.05 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $9,772.37
| Facility | | $1,862.09 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $426.58 / $812.83
| Professional | | $229.09 | $426.58 | $812.83 |