- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $4,466.84 / $5,495.41
| Facility | | $1,412.54 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $134.90 / $302.00
| Professional | | $75.86 | $134.90 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $199.53 / $199.53 / $346.74
| Professional | 50 | $199.53 | $199.53 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $1,318.26 / $2,187.76
| Facility | | $316.23 | $1,318.26 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $467.74 / $2,041.74 / $3,235.94
| Facility | 50 | $467.74 | $2,041.74 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $204.17 / $263.03
| Professional | | $134.90 | $204.17 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $218.78 / $380.19 / $398.11
| Professional | 50 | $218.78 | $380.19 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $446.68
| Facility | | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $147.91 / $234.42
| Professional | | $97.72 | $147.91 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $173.78 / $371.54
| Facility | | $79.43 | $173.78 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $190.55 / $302.00
| Professional | | $123.03 | $190.55 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $199.53 / $199.53 / $346.74
| Professional | 50 | $199.53 | $199.53 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,548.82 / $2,238.72
| Facility | | $1,258.93 | $1,548.82 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,862.09 / $2,630.27 / $3,388.44
| Facility | 50 | $1,862.09 | $2,630.27 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $186.21 / $281.84
| Professional | | $125.89 | $186.21 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $141.25 / $1,202.26
| Professional | | $89.13 | $141.25 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $2,630.27 / $4,466.84
| Facility | | $446.68 | $2,630.27 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $154.88 / $251.19
| Professional | | $93.33 | $154.88 | $251.19 |