- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,398.83 / $5,754.40
| Facility | | $660.69 | $2,398.83 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $630.96 / $1,659.59 / $2,884.03
| Facility | 50 | $630.96 | $1,659.59 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $331.13 / $1,258.93
| Professional | | $144.54 | $331.13 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $162.18 / $812.83 / $3,630.78
| Professional | 50 | $162.18 | $812.83 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $5,128.61 / $28,840.32
| Facility | | $371.54 | $5,128.61 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $7,585.78 / $7,585.78 / $7,585.78
| Facility | 52 | $7,585.78 | $7,585.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $1,862.09
| Facility | 53 | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $416.87 / $1,202.26
| Professional | | $165.96 | $416.87 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $177.83 / $416.87
| Facility | | $177.83 | $177.83 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $457.09 / $977.24
| Professional | | $263.03 | $457.09 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $524.81 / $1,288.25
| Professional | | $199.53 | $524.81 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $501.19 / $7,079.46
| Facility | | $144.54 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $446.68 / $660.69
| Professional | | $234.42 | $446.68 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $389.05 / $977.24
| Professional | | $169.82 | $389.05 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,890.45 / $7,585.78
| Facility | | $1,023.29 | $3,890.45 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $371.54 / $537.03
| Professional | | $165.96 | $371.54 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $5,370.32 / $28,840.32
| Facility | | $371.54 | $5,370.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $7,585.78 / $7,585.78 / $7,585.78
| Facility | 52 | $7,585.78 | $7,585.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $1,862.09
| Facility | 53 | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $407.38 / $1,202.26
| Professional | | $165.96 | $407.38 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $9,772.37
| Facility | | $1,862.09 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $436.52 / $1,096.48
| Professional | | $173.78 | $436.52 | $1,096.48 |