- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $187.29 / $1,700.06 / $3,124.50
| Facility | | $187.29 | $1,700.06 | $3,124.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $348.76 / $2,482.33 / $4,833.56
| Facility | 50 | $348.76 | $2,482.33 | $4,833.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.29 / $170.90 / $350.35
| Professional | | $87.29 | $170.90 | $350.35 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $155.22 / $438.75 / $1,054.20
| Professional | 50 | $155.22 | $438.75 | $1,054.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $210.88 / $1,483.60 / $7,161.00
| Facility | | $210.88 | $1,483.60 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.47 / $278.95 / $776.25
| Professional | | $106.47 | $278.95 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.86 / $136.03 / $269.94
| Facility | | $105.86 | $136.03 | $269.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.97 / $215.86 / $448.28
| Professional | | $54.97 | $215.86 | $448.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.12 / $229.63 / $443.56
| Professional | | $124.12 | $229.63 | $443.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.96 / $300.00 / $6,679.00
| Facility | | $91.96 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.46 / $250.67 / $346.35
| Professional | | $205.46 | $250.67 | $346.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.41 / $248.25 / $523.64
| Professional | | $117.41 | $248.25 | $523.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.04 / $1,836.18 / $3,413.34
| Facility | | $655.04 | $1,836.18 | $3,413.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.07 / $278.66 / $438.63
| Professional | | $145.07 | $278.66 | $438.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $452.96 / $2,078.00 / $30,000.00
| Facility | | $452.96 | $2,078.00 | $30,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $211.04 / $418.65 / $3,100.00
| Professional | | $211.04 | $418.65 | $3,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $928.79 / $1,480.18 / $2,605.06
| Facility | | $928.79 | $1,480.18 | $2,605.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.56 / $340.73 / $580.54
| Professional | | $202.56 | $340.73 | $580.54 |