- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $1,995.26 / $6,456.54
| Facility | | $407.38 | $1,995.26 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $794.33 / $2,398.83 / $9,549.93
| Facility | 50 | $794.33 | $2,398.83 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $309.03 / $478.63
| Professional | | $177.83 | $309.03 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $32.36 / $309.03 / $1,584.89
| Professional | 50 | $32.36 | $309.03 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $114.82 / $134.90 / $151.36
| Professional | 50 | $114.82 | $134.90 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $5,011.87 / $7,943.28
| Facility | | $3,235.94 | $5,011.87 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $331.13 / $380.19
| Professional | | $213.80 | $331.13 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $363.08 / $575.44
| Professional | | $186.21 | $363.08 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $891.25 / $5,495.41
| Facility | | $208.93 | $891.25 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,122.02 / $1,122.02 / $3,715.35
| Facility | 50 | $1,122.02 | $1,122.02 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $426.58 / $3,801.89
| Professional | | $251.19 | $426.58 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $3,311.31 / $6,025.60
| Facility | | $891.25 | $3,311.31 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $295.12 / $478.63
| Professional | | $165.96 | $295.12 | $478.63 |