- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $1,548.82 / $5,495.41
| Facility | | $436.52 | $1,548.82 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $588.84 / $1,288.25
| Professional | | $338.84 | $588.84 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,715.35 / $8,317.64
| Facility | | $1,380.38 | $3,715.35 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,548.82 / $5,011.87 / $12,589.25
| Facility | 50 | $1,548.82 | $5,011.87 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $660.69 / $794.33
| Professional | | $478.63 | $660.69 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $645.65 / $1,096.48 / $1,202.26
| Professional | 50 | $645.65 | $1,096.48 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $602.56 / $870.96
| Professional | | $416.87 | $602.56 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $954.99 / $3,388.44
| Facility | | $416.87 | $954.99 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $660.69 / $891.25
| Professional | | $407.38 | $660.69 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $7,244.36 / $10,471.29
| Facility | | $5,623.41 | $7,244.36 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,511.38 / $12,022.64 / $15,488.17
| Facility | 50 | $8,511.38 | $12,022.64 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $562.34 / $912.01
| Professional | | $501.19 | $562.34 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $501.19 / $6,760.83
| Professional | | $380.19 | $501.19 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $16,982.44 / $18,197.01
| Facility | | $9,332.54 | $16,982.44 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $660.69 / $1,202.26
| Professional | | $354.81 | $660.69 | $1,202.26 |