- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $1,412.54 / $5,495.41
| Facility | | $316.23 | $1,412.54 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $239.88 / $446.68
| Professional | | $120.23 | $239.88 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $407.38 / $741.31
| Facility | | $218.78 | $407.38 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $295.12 / $562.34 / $1,071.52
| Facility | 50 | $295.12 | $562.34 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $295.12 / $363.08
| Professional | | $204.17 | $295.12 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $281.84 / $501.19 / $549.54
| Professional | 50 | $281.84 | $501.19 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $213.80 / $316.23
| Professional | | $123.03 | $213.80 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $269.15 / $707.95
| Facility | | $128.82 | $269.15 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $213.80 / $371.54
| Professional | | $151.36 | $213.80 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $77.62
| Professional | | $30.20 | $30.20 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $588.84 / $776.25
| Facility | | $436.52 | $588.84 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $660.69 / $891.25 / $1,148.15
| Facility | 50 | $660.69 | $891.25 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $234.42 / $389.05
| Professional | | $147.91 | $234.42 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $204.17 / $588.84
| Professional | | $173.78 | $204.17 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $8,317.64 / $9,332.54
| Facility | | $1,819.70 | $8,317.64 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $194.98 / $331.13
| Professional | | $114.82 | $194.98 | $331.13 |