- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $3,981.07 / $8,317.64
| Facility | | $912.01 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,398.83 / $2,398.83 / $2,398.83
| Facility | 50 | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $467.74 / $1,023.29
| Professional | | $346.74 | $467.74 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $363.08 / $363.08
| Professional | | $323.59 | $363.08 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $3,801.89 / $57,543.99
| Facility | | $3,801.89 | $3,801.89 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $446.68 / $794.33
| Professional | | $426.58 | $446.68 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $478.63 / $478.63
| Facility | | $478.63 | $478.63 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $446.68 / $724.44
| Professional | | $323.59 | $446.68 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $549.54 / $741.31
| Professional | | $549.54 | $549.54 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $446.68 / $741.31
| Professional | | $371.54 | $446.68 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.50 / $3,235.94 / $3,311.31
| Facility | | $0.50 | $3,235.94 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $478.63 / $549.54
| Professional | | $407.38 | $478.63 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,691.53 / $8,317.64
| Facility | | $831.76 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,398.83 / $2,398.83 / $2,398.83
| Facility | 50 | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $489.78 / $1,122.02
| Professional | | $363.08 | $489.78 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $549.54 / $851.14
| Professional | | $549.54 | $549.54 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $416.87 / $489.78
| Facility | | $407.38 | $416.87 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $416.87 / $489.78
| Professional | | $371.54 | $416.87 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $7,585.78
| Facility | | $1,348.96 | $3,548.13 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $446.68 / $758.58
| Professional | | $331.13 | $446.68 | $758.58 |