- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.67 / $982.50 / $2,936.73
| Facility | | $67.67 | $982.50 | $2,936.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.43 / $103.59 / $194.22
| Professional | | $60.43 | $103.59 | $194.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,184.58 / $2,481.89 / $3,985.33
| Facility | | $1,184.58 | $2,481.89 | $3,985.33 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,078.36 / $3,153.33 / $5,529.09
| Facility | 50 | $2,078.36 | $3,153.33 | $5,529.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.72 / $241.66 / $471.59
| Professional | | $133.72 | $241.66 | $471.59 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $192.95 / $360.89 / $686.16
| Professional | 50 | $192.95 | $360.89 | $686.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.89 / $476.58 / $1,146.48
| Facility | | $335.89 | $476.58 | $1,146.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.19 / $284.85 / $543.71
| Professional | | $144.19 | $284.85 | $543.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.20 / $435.71 / $902.74
| Facility | | $273.20 | $435.71 | $902.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.50 / $259.06 / $468.02
| Professional | | $145.50 | $259.06 | $468.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.82 / $207.04 / $1,671.69
| Facility | | $93.82 | $207.04 | $1,671.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.83 / $236.85 / $1,227.00
| Professional | | $127.83 | $236.85 | $1,227.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $350.68 / $350.68 / $355.30
| Professional | 50 | $350.68 | $350.68 | $355.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,187.00 / $2,872.00 / $4,241.00
| Facility | | $1,187.00 | $2,872.00 | $4,241.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.03 / $234.60 / $459.88
| Professional | | $129.03 | $234.60 | $459.88 |