- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $2,951.21 / $8,317.64
| Facility | | $363.08 | $2,951.21 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $870.96 / $1,862.09 / $6,309.57
| Facility | 50 | $870.96 | $1,862.09 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $281.84 / $588.84
| Professional | | $158.49 | $281.84 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $363.08 / $645.65 / $1,584.89
| Professional | 50 | $363.08 | $645.65 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $251.19 / $380.19
| Professional | | $151.36 | $251.19 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $269.15 / $389.05 / $512.86
| Professional | 50 | $269.15 | $389.05 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $794.33 / $1,659.59
| Facility | | $269.15 | $794.33 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $288.40 / $549.54
| Professional | | $165.96 | $288.40 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $4,786.30 / $9,549.93
| Facility | | $2,691.53 | $4,786.30 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $199.53 / $309.03
| Professional | | $186.21 | $199.53 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $309.03
| Professional | | $32.36 | $33.11 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $3,548.13 / $6,760.83
| Facility | | $933.25 | $3,548.13 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $257.04 / $467.74
| Professional | | $151.36 | $257.04 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $204.17 / $263.03
| Professional | | $123.03 | $204.17 | $263.03 |