- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $1,513.56 / $3,630.78
| Facility | | $204.17 | $1,513.56 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,412.54 / $1,412.54 / $2,630.27
| Facility | 50 | $1,412.54 | $1,412.54 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $204.17 / $741.31
| Professional | | $66.07 | $204.17 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $147.91 / $213.80 / $457.09
| Professional | 50 | $147.91 | $213.80 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $630.96 / $2,818.38
| Facility | | $56.23 | $630.96 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $208.93 / $741.31
| Professional | | $70.79 | $208.93 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $75.86 / $177.83
| Facility | | $75.86 | $75.86 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $309.03 / $575.44
| Professional | | $109.65 | $309.03 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $177.83 / $575.44
| Professional | | $85.11 | $177.83 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $177.83 / $7,079.46
| Facility | | $58.88 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $389.05 / $489.78
| Professional | | $316.23 | $389.05 | $489.78 |
- 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
- $69.18 / $239.88 / $676.08
| Professional | | $69.18 | $239.88 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $954.99 / $2,089.30
| Facility | | $776.25 | $954.99 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $223.87 / $446.68
| Professional | | $223.87 | $223.87 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $630.96 / $2,818.38
| Facility | | $56.23 | $630.96 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $208.93 / $724.44
| Professional | | $70.79 | $208.93 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,862.09 / $2,818.38
| Facility | | $630.96 | $1,862.09 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $190.55 / $630.96
| Professional | | $75.86 | $190.55 | $630.96 |