- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $2,089.30 / $3,715.35
| Facility | | $331.13 | $2,089.30 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,819.70 / $1,819.70 / $1,819.70
| Facility | 50 | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $251.19 / $1,174.90
| Professional | | $52.48 | $251.19 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,288.25 / $3,801.89
| Facility | | $56.23 | $1,288.25 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $331.13 / $1,230.27
| Professional | | $54.95 | $331.13 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $138.04
| Facility | | $60.26 | $60.26 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $120.23 / $977.24
| Professional | | $120.23 | $120.23 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $275.42 / $1,148.15
| Professional | | $69.18 | $275.42 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $380.19 / $7,079.46
| Facility | | $56.23 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $478.63 / $724.44
| Professional | | $257.04 | $478.63 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,511.89 / $7,079.46
| Facility | | $1,096.48 | $2,511.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $407.38 / $1,023.29
| Professional | | $54.95 | $407.38 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $1,949.84 / $2,630.27
| Facility | | $1,819.70 | $1,949.84 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,348.96 / $3,801.89
| Facility | | $56.23 | $1,348.96 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $331.13 / $1,202.26
| Professional | | $54.95 | $331.13 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,290.87 / $6,165.95
| Facility | | $954.99 | $2,290.87 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $302.00 / $1,047.13
| Professional | | $61.66 | $302.00 | $1,047.13 |