- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $1,995.26 / $3,715.35
| Facility | | $138.04 | $1,995.26 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $575.44 / $776.25 / $1,995.26
| Facility | 50 | $575.44 | $776.25 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $181.97 / $562.34
| Professional | | $117.49 | $181.97 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $204.17 / $562.34 / $1,174.90
| Professional | 50 | $204.17 | $562.34 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $602.56 / $2,818.38
| Facility | | $56.23 | $602.56 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $199.53 / $478.63
| Professional | | $114.82 | $199.53 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $141.25 / $323.59
| Facility | | $141.25 | $141.25 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $213.80 / $380.19
| Professional | | $141.25 | $213.80 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $218.78 / $338.84
| Professional | | $134.90 | $218.78 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $218.78 / $7,079.46
| Facility | | $109.65 | $218.78 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $199.53 / $288.40
| Professional | | $162.18 | $199.53 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $218.78 / $380.19
| Professional | | $131.83 | $218.78 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $524.81 / $741.31
| Facility | | $165.96 | $524.81 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $346.74 / $446.68
| Professional | | $257.04 | $346.74 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $602.56 / $2,818.38
| Facility | | $56.23 | $602.56 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $199.53 / $478.63
| Professional | | $114.82 | $199.53 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $208.93 / $389.05
| Professional | | $128.82 | $208.93 | $389.05 |