- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $3,311.31 / $8,709.64
| Facility | | $316.23 | $3,311.31 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $776.25 / $1,698.24 / $5,623.41
| Facility | 50 | $776.25 | $1,698.24 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $229.09 / $524.81
| Professional | | $131.83 | $229.09 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $436.52 / $1,479.11 / $2,398.83
| Professional | 50 | $436.52 | $1,479.11 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $346.74 / $346.74
| Professional | | $346.74 | $346.74 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $295.12 / $389.05 / $776.25
| Professional | 50 | $295.12 | $389.05 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $186.21 / $323.59
| Facility | | $34.67 | $186.21 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $275.42 / $549.54
| Professional | | $151.36 | $275.42 | $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
- $199.53 / $208.93 / $281.84
| Professional | | $199.53 | $208.93 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $338.84
| Professional | | $32.36 | $33.11 | $338.84 |
- 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
- $138.04 / $251.19 / $457.09
| Professional | | $138.04 | $251.19 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $218.78 / $281.84
| Professional | | $114.82 | $218.78 | $281.84 |