- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $3,019.95 / $7,585.78
| Facility | | $269.15 | $3,019.95 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,168.69 / $4,168.69 / $4,168.69
| Facility | 50 | $4,168.69 | $4,168.69 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $245.47 / $537.03
| Professional | | $120.23 | $245.47 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $1,047.13 / $1,096.48 / $1,122.02
| Professional | 50 | $1,047.13 | $1,096.48 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $147.91 / $263.03
| Professional | | $114.82 | $147.91 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $354.81 / $354.81 / $354.81
| Professional | 50 | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $1,047.13 / $1,122.02
| Facility | | $323.59 | $1,047.13 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $457.09
| Professional | | $229.09 | $229.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $331.13
| Facility | | $331.13 | $331.13 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $251.19 / $467.74
| Professional | | $138.04 | $251.19 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $363.08 / $1,995.26
| Facility | | $151.36 | $363.08 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $371.54 / $1,995.26
| Professional | | $257.04 | $371.54 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $794.33 / $2,570.40
| Facility | | $524.81 | $794.33 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $239.88 / $416.87
| Professional | | $134.90 | $239.88 | $416.87 |