- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $386.50 / $2,444.21 / $7,630.59
| Facility | | $386.50 | $2,444.21 | $7,630.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.93 / $157.47 / $507.92
| Professional | | $73.93 | $157.47 | $507.92 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $153.22 / $153.22 / $1,571.75
| Professional | 50 | $153.22 | $153.22 | $1,571.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.40 / $114.07 / $205.53
| Professional | | $74.40 | $114.07 | $205.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.04 / $816.67 / $1,288.46
| Facility | | $382.04 | $816.67 | $1,288.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.20 / $116.40 / $197.63
| Professional | | $69.20 | $116.40 | $197.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,529.27 / $1,529.27 / $1,965.14
| Facility | | $1,529.27 | $1,529.27 | $1,965.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.10 / $196.01 / $360.50
| Professional | | $98.10 | $196.01 | $360.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.98 / $197.76 / $308.12
| Facility | | $86.98 | $197.76 | $308.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,061.83 / $1,353.04 / $1,606.69
| Professional | | $1,061.83 | $1,353.04 | $1,606.69 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $1,592.75 / $1,592.75 / $2,410.04
| Professional | 50 | $1,592.75 | $1,592.75 | $2,410.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.14 / $187.03 / $285.87
| Professional | | $137.14 | $187.03 | $285.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,607.00 / $8,667.00
| Facility | | $659.00 | $6,607.00 | $8,667.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.38 / $234.99 / $409.66
| Professional | | $161.38 | $234.99 | $409.66 |