- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.96 / $764.36 / $2,487.42
| Facility | | $119.96 | $764.36 | $2,487.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.96 / $576.19 / $1,211.25
| Professional | | $119.96 | $576.19 | $1,211.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.33 / $2,656.15 / $5,761.70
| Facility | | $608.33 | $2,656.15 | $5,761.70 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,696.87 / $5,608.96 / $9,834.81
| Facility | 50 | $3,696.87 | $5,608.96 | $9,834.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.52 / $708.46 / $1,729.62
| Professional | | $225.52 | $708.46 | $1,729.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,292.03 / $1,832.26 / $4,407.76
| Facility | | $1,292.03 | $1,832.26 | $4,407.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.25 / $853.22 / $2,156.67
| Professional | | $295.25 | $853.22 | $2,156.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,050.33 / $1,675.13 / $3,470.68
| Facility | | $1,050.33 | $1,675.13 | $3,470.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.63 / $755.64 / $1,873.75
| Professional | | $262.63 | $755.64 | $1,873.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $210.78 / $799.76 / $2,409.17
| Facility | | $210.78 | $799.76 | $2,409.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $711.65 / $1,547.79 / $2,355.26
| Professional | | $711.65 | $1,547.79 | $2,355.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,296.00 / $3,500.00 / $6,361.00
| Facility | | $2,296.00 | $3,500.00 | $6,361.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.86 / $1,393.30 / $2,155.08
| Professional | | $435.86 | $1,393.30 | $2,155.08 |