- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $2,238.72 / $3,801.89
| Facility | | $204.17 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $707.95 / $1,047.13 / $1,348.96
| Facility | 50 | $707.95 | $1,047.13 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $169.82 / $457.09
| Professional | | $104.71 | $169.82 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $177.83 / $691.83 / $1,174.90
| Professional | 50 | $177.83 | $691.83 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,174.90 / $3,801.89
| Facility | | $56.23 | $1,174.90 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $208.93 / $478.63
| Professional | | $117.49 | $208.93 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $125.89 / $288.40
| Facility | | $125.89 | $125.89 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $239.88 / $407.38
| Professional | | $131.83 | $239.88 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $194.98 / $7,079.46
| Facility | | $91.20 | $194.98 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $223.87 / $323.59
| Professional | | $181.97 | $223.87 | $323.59 |
- 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
- $112.20 / $204.17 / $416.87
| Professional | | $112.20 | $204.17 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,071.52 / $1,071.52
| Facility | | $1,071.52 | $1,071.52 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $257.04 / $257.04
| Professional | | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,174.90 / $3,801.89
| Facility | | $56.23 | $1,174.90 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $208.93 / $467.74
| Professional | | $117.49 | $208.93 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,344.23 / $6,165.95
| Facility | | $954.99 | $2,344.23 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $213.80 / $436.52
| Professional | | $123.03 | $213.80 | $436.52 |