- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.37 / $825.48 / $4,032.94
| Facility | | $398.37 | $825.48 | $4,032.94 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,584.83 / $5,348.46 / $5,348.46
| Facility | 50 | $3,584.83 | $5,348.46 | $5,348.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $365.53 / $398.37 / $515.35
| Professional | | $365.53 | $398.37 | $515.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.25 / $428.17 / $612.33
| Professional | | $389.25 | $428.17 | $612.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $583.87 / $642.26 / $918.50
| Professional | 50 | $583.87 | $642.26 | $918.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.37 / $530.92 / $694.84
| Professional | | $399.37 | $530.92 | $694.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $357.71 / $460.71 / $706.75
| Professional | | $357.71 | $460.71 | $706.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $365.44 / $825.48 / $4,206.31
| Facility | | $365.44 | $825.48 | $4,206.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,584.83 / $3,584.83 / $5,348.46
| Facility | 50 | $3,584.83 | $3,584.83 | $5,348.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $365.53 / $398.37 / $593.85
| Professional | | $365.53 | $398.37 | $593.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $449.58 / $565.72 / $702.55
| Professional | | $449.58 | $565.72 | $702.55 |