- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $448.93 / $2,106.23 / $3,603.67
| Facility | | $448.93 | $2,106.23 | $3,603.67 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $639.38 / $1,986.00 / $5,209.10
| Facility | 50 | $639.38 | $1,986.00 | $5,209.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $203.92 / $407.68 / $812.70
| Professional | | $203.92 | $407.68 | $812.70 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $465.08 / $740.26 / $1,922.78
| Professional | 50 | $465.08 | $740.26 | $1,922.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $447.65 / $2,854.00 / $9,039.00
| Facility | | $447.65 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.88 / $634.99 / $1,838.91
| Professional | | $243.88 | $634.99 | $1,838.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.67 / $287.42 / $570.36
| Facility | | $223.67 | $287.42 | $570.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.08 / $464.50 / $1,243.35
| Professional | | $89.08 | $464.50 | $1,243.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.75 / $528.61 / $1,093.19
| Professional | | $267.75 | $528.61 | $1,093.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.81 / $301.48 / $6,679.00
| Facility | | $190.81 | $301.48 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503.68 / $614.52 / $851.59
| Professional | | $503.68 | $614.52 | $851.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.97 / $545.79 / $1,279.55
| Professional | | $259.97 | $545.79 | $1,279.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.76 / $2,482.76 / $3,485.04
| Facility | | $1,615.76 | $2,482.76 | $3,485.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.30 / $707.00 / $1,097.29
| Professional | | $301.30 | $707.00 | $1,097.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,100.65 / $3,764.00 / $40,000.00
| Facility | | $1,100.65 | $3,764.00 | $40,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $511.40 / $914.00 / $3,135.84
| Professional | | $511.40 | $914.00 | $3,135.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.72 / $731.51 / $1,346.17
| Professional | | $465.72 | $731.51 | $1,346.17 |