- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $1,621.81 / $4,466.84
| Facility | | $446.68 | $1,621.81 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $977.24 / $3,235.94 / $8,709.64
| Facility | 50 | $977.24 | $3,235.94 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $416.87 / $1,348.96
| Professional | | $190.55 | $416.87 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $281.84 / $537.03 / $2,041.74
| Professional | 50 | $281.84 | $537.03 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $208.93 / $478.63
| Professional | | $165.96 | $208.93 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $257.04 / $323.59 / $645.65
| Professional | 50 | $257.04 | $323.59 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,951.21 / $4,365.16
| Facility | | $1,584.89 | $2,951.21 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $398.11 / $691.83
| Professional | | $223.87 | $398.11 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $1,412.54 / $1,412.54
| Facility | | $39.81 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $398.11
| Facility | | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $380.19 / $676.08
| Professional | | $213.80 | $380.19 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,398.83 / $5,888.44
| Facility | | $831.76 | $2,398.83 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $380.19 / $724.44
| Professional | | $199.53 | $380.19 | $724.44 |