- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $2,187.76 / $3,801.89
| Facility | | $138.04 | $2,187.76 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $131.83 / $309.03
| Professional | | $60.26 | $131.83 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $208.93 / $208.93 / $208.93
| Professional | 50 | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $1,862.09 / $19,498.45
| Facility | | $144.54 | $1,862.09 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $165.96 / $489.78
| Professional | | $67.61 | $165.96 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $74.13 / $169.82
| Facility | | $74.13 | $74.13 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $245.47 / $363.08
| Professional | | $97.72 | $245.47 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $154.88 / $354.81
| Professional | | $79.43 | $154.88 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $131.83 / $7,079.46
| Facility | | $63.10 | $131.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $263.03 / $331.13
| Professional | | $218.78 | $263.03 | $331.13 |
- 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
- $74.13 / $190.55 / $478.63
| Professional | | $74.13 | $190.55 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.41 / $0.41 / $0.41
| Facility | | $0.41 | $0.41 | $0.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $1,862.09 / $19,498.45
| Facility | | $144.54 | $1,862.09 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $165.96 / $489.78
| Professional | | $67.61 | $165.96 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,454.71 / $6,165.95
| Facility | | $1,047.13 | $2,454.71 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $165.96 / $446.68
| Professional | | $74.13 | $165.96 | $446.68 |