- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $187.78 / $447.61 / $3,429.41
| Facility | | $187.78 | $447.61 | $3,429.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,459.78 / $2,459.78 / $2,459.78
| Facility | 50 | $2,459.78 | $2,459.78 | $2,459.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $187.78 / $425.72 / $992.70
| Professional | | $187.78 | $425.72 | $992.70 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $276.74 / $281.82 / $407.75
| Professional | 50 | $276.74 | $281.82 | $407.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.92 / $731.22 / $1,257.27
| Professional | | $403.92 | $731.22 | $1,257.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $271.25 / $586.29 / $1,027.77
| Facility | | $271.25 | $586.29 | $1,027.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.72 / $961.99 / $3,260.40
| Professional | | $476.72 | $961.99 | $3,260.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.82 / $938.14 / $2,173.59
| Facility | | $478.82 | $938.14 | $2,173.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.28 / $637.37 / $1,104.91
| Professional | | $466.28 | $637.37 | $1,104.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.29 / $598.54 / $833.85
| Professional | | $317.29 | $598.54 | $833.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,714.00 / $2,714.00 / $2,714.00
| Facility | | $2,714.00 | $2,714.00 | $2,714.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $443.86 / $760.45 / $1,182.92
| Professional | | $443.86 | $760.45 | $1,182.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.30 / $453.10 / $1,012.10
| Professional | | $370.30 | $453.10 | $1,012.10 |