- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $537.03 / $9,332.54
| Facility | | $371.54 | $537.03 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $371.54 / $2,041.74 / $12,589.25
| Facility | 50 | $371.54 | $2,041.74 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $13,803.84 / $21,877.62
| Facility | | $10,000.00 | $13,803.84 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,318.26 / $2,089.30
| Facility | | $1,122.02 | $1,318.26 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $4,265.80 / $7,762.47
| Facility | | $512.86 | $4,265.80 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $7,244.36 / $13,803.84
| Facility | | $489.78 | $7,244.36 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.65 / $1,348.96 / $2,951.21
| Facility | 50 | $0.65 | $1,348.96 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $954.99 / $1,621.81
| Professional | | $489.78 | $954.99 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $9,332.54 / $13,803.84
| Facility | | $9,332.54 | $9,332.54 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $14,454.40
| Facility | | $6,606.93 | $10,232.93 | $14,454.40 |