- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $2,089.30 / $3,715.35
| Facility | | $489.78 | $2,089.30 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $616.60 / $1,071.52 / $5,248.07
| Facility | 50 | $616.60 | $1,071.52 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $512.86 / $1,995.26
| Professional | | $100.00 | $512.86 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $165.96 / $512.86 / $3,630.78
| Professional | 50 | $165.96 | $512.86 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,288.25 / $5,495.41
| Facility | | $56.23 | $1,288.25 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $478.63 / $1,698.24
| Professional | | $104.71 | $478.63 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $112.20 / $263.03
| Facility | | $112.20 | $112.20 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $223.87 / $1,412.54
| Professional | | $223.87 | $223.87 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $512.86 / $1,737.80
| Professional | | $131.83 | $512.86 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $186.21 / $7,079.46
| Facility | | $89.13 | $186.21 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $645.65 / $1,023.29
| Professional | | $363.08 | $645.65 | $1,023.29 |
- 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
- $107.15 / $575.44 / $1,445.44
| Professional | | $107.15 | $575.44 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $2,454.71 / $4,570.88
| Facility | | $117.49 | $2,454.71 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,288.25 / $5,495.41
| Facility | | $56.23 | $1,288.25 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $478.63 / $1,698.24
| Professional | | $104.71 | $478.63 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,511.89 / $6,918.31
| Facility | | $1,047.13 | $2,511.89 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $446.68 / $1,513.56
| Professional | | $123.03 | $446.68 | $1,513.56 |