- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,238.72 / $3,801.89
| Facility | | $467.74 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $338.84 / $758.58
| Professional | | $144.54 | $338.84 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $208.93 / $208.93 / $208.93
| Professional | 50 | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,884.03 / $5,754.40
| Facility | | $56.23 | $2,884.03 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $4,168.69 / $4,168.69 / $4,168.69
| Facility | 52 | $4,168.69 | $4,168.69 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $457.09 / $1,380.38
| Professional | | $173.78 | $457.09 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $169.82 / $398.11
| Facility | | $169.82 | $169.82 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $363.08 / $891.25
| Professional | | $181.97 | $363.08 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $223.87 / $7,079.46
| Facility | | $134.90 | $223.87 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $588.84 / $831.76
| Professional | | $489.78 | $588.84 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $426.58 / $1,071.52
| Professional | | $162.18 | $426.58 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,801.89 / $9,120.11
| Facility | | $56.23 | $3,801.89 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $4,168.69 / $4,168.69 / $4,168.69
| Facility | 52 | $4,168.69 | $4,168.69 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $457.09 / $1,380.38
| Professional | | $173.78 | $457.09 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,981.07 / $9,120.11
| Facility | | $1,862.09 | $3,981.07 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $416.87 / $1,071.52
| Professional | | $165.96 | $416.87 | $1,071.52 |