- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $1,905.46 / $3,388.44
| Facility | | $489.78 | $1,905.46 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $234.42 / $2,089.30 / $5,128.61
| Facility | 50 | $234.42 | $2,089.30 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $204.17 / $562.34
| Professional | | $104.71 | $204.17 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $162.18 / $398.11 / $1,096.48
| Professional | 50 | $162.18 | $398.11 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $1,862.09 / $30,199.52
| Facility | | $245.47 | $1,862.09 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $229.09 / $575.44
| Professional | | $114.82 | $229.09 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $123.03 / $288.40
| Facility | | $123.03 | $123.03 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $288.40 / $537.03
| Professional | | $173.78 | $288.40 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $251.19 / $478.63
| Professional | | $131.83 | $251.19 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $204.17 / $7,079.46
| Facility | | $95.50 | $204.17 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $295.12 / $407.38
| Professional | | $239.88 | $295.12 | $407.38 |
- 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
- $114.82 / $245.47 / $537.03
| Professional | | $114.82 | $245.47 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,905.46 / $3,388.44
| Facility | | $933.25 | $1,905.46 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $269.15
| Professional | | $213.80 | $213.80 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $1,862.09 / $30,199.52
| Facility | | $245.47 | $1,862.09 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $229.09 / $575.44
| Professional | | $114.82 | $229.09 | $575.44 |
- 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
- $117.49 / $245.47 / $549.54
| Professional | | $117.49 | $245.47 | $549.54 |