- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,730.54 / $3,163.42 / $5,628.72
| Facility | | $1,730.54 | $3,163.42 | $5,628.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $8,242.08 / $9,875.64 / $11,257.44
| Facility | 50 | $8,242.08 | $9,875.64 | $11,257.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.20 / $400.45 / $506.62
| Professional | | $191.20 | $400.45 | $506.62 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $600.67 / $608.41 / $624.27
| Professional | 50 | $600.67 | $608.41 | $624.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.27 / $216.32 / $297.45
| Facility | | $180.27 | $216.32 | $297.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.80 / $606.08 / $878.27
| Professional | | $378.80 | $606.08 | $878.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.12 / $326.12 / $326.12
| Facility | | $326.12 | $326.12 | $326.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.33 / $454.56 / $899.60
| Professional | | $216.33 | $454.56 | $899.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,424.77 / $3,176.23 / $6,858.85
| Facility | | $1,424.77 | $3,176.23 | $6,858.85 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,061.58 / $8,207.98 / $10,520.81
| Facility | 50 | $2,061.58 | $8,207.98 | $10,520.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.45 / $576.61 / $793.57
| Professional | | $315.45 | $576.61 | $793.57 |