- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $1,819.70 / $3,715.35
| Facility | | $165.96 | $1,819.70 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $281.84 / $1,202.26 / $1,202.26
| Facility | 50 | $281.84 | $1,202.26 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $223.87 / $707.95
| Professional | | $75.86 | $223.87 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $56.23 / $302.00 / $741.31
| Professional | 50 | $56.23 | $302.00 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $1,023.29 / $19,498.45
| Facility | | $186.21 | $1,023.29 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $208.93 / $724.44
| Professional | | $81.28 | $208.93 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $87.10 / $204.17
| Facility | | $87.10 | $87.10 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $288.40 / $501.19
| Professional | | $87.10 | $288.40 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $281.84 / $707.95
| Professional | | $112.20 | $281.84 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $380.19 / $7,079.46
| Facility | | $83.18 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $398.11 / $524.81
| Professional | | $316.23 | $398.11 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $269.15 / $660.69
| Professional | | $85.11 | $269.15 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $1,071.52 / $19,498.45
| Facility | | $186.21 | $1,071.52 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $204.17 / $707.95
| Professional | | $81.28 | $204.17 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $1,819.70 / $2,818.38
| Facility | | $338.84 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $218.78 / $630.96
| Professional | | $95.50 | $218.78 | $630.96 |