- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $2,187.76 / $3,630.78
| Facility | | $446.68 | $2,187.76 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $691.83 / $2,951.21 / $6,025.60
| Facility | 50 | $691.83 | $2,951.21 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $436.52 / $1,318.26
| Professional | | $194.98 | $436.52 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $275.42 / $630.96 / $2,754.23
| Professional | 50 | $275.42 | $630.96 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $3,890.45 / $39,810.72
| Facility | | $446.68 | $3,890.45 | $39,810.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $512.86 / $1,258.93
| Professional | | $208.93 | $512.86 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $223.87 / $524.81
| Facility | | $223.87 | $223.87 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $660.69 / $1,202.26
| Professional | | $316.23 | $660.69 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $478.63 / $1,047.13
| Professional | | $251.19 | $478.63 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $295.12 / $7,079.46
| Facility | | $173.78 | $295.12 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $676.08 / $933.25
| Professional | | $549.54 | $676.08 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $489.78 / $1,202.26
| Professional | | $208.93 | $489.78 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,019.95 / $3,548.13
| Facility | | $2,089.30 | $3,019.95 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $707.95 / $741.31
| Professional | | $223.87 | $707.95 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $3,890.45 / $39,810.72
| Facility | | $446.68 | $3,890.45 | $39,810.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $512.86 / $1,258.93
| Professional | | $208.93 | $512.86 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,981.07 / $9,120.11
| Facility | | $1,862.09 | $3,981.07 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $512.86 / $1,202.26
| Professional | | $251.19 | $512.86 | $1,202.26 |