- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.53 / $352.39 / $2,035.05
| Facility | | $96.53 | $352.39 | $2,035.05 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,817.21 / $1,817.21 / $1,928.03
| Facility | 50 | $1,817.21 | $1,817.21 | $1,928.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.72 / $119.66 / $470.40
| Professional | | $52.72 | $119.66 | $470.40 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $35.79 / $177.95 / $635.89
| Professional | 50 | $35.79 | $177.95 | $635.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.15 / $1,004.27 / $2,211.92
| Facility | | $440.15 | $1,004.27 | $2,211.92 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $772.24 / $1,171.66 / $2,054.41
| Facility | 50 | $772.24 | $1,171.66 | $2,054.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.56 / $220.45 / $383.87
| Professional | | $152.56 | $220.45 | $383.87 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $217.37 / $322.67 / $533.87
| Professional | 50 | $217.37 | $322.67 | $533.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.17 / $398.94 / $959.71
| Facility | | $281.17 | $398.94 | $959.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.29 / $282.31 / $480.54
| Professional | | $168.29 | $282.31 | $480.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $228.69 / $364.73 / $755.68
| Facility | | $228.69 | $364.73 | $755.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.53 / $260.22 / $451.67
| Professional | | $164.53 | $260.22 | $451.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.14 / $226.28 / $1,097.33
| Facility | | $113.14 | $226.28 | $1,097.33 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $590.71 / $1,068.11 / $1,793.28
| Facility | 50 | $590.71 | $1,068.11 | $1,793.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.46 / $259.80 / $822.85
| Professional | | $132.46 | $259.80 | $822.85 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $270.66 / $393.44 / $1,085.40
| Professional | 50 | $270.66 | $393.44 | $1,085.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.00 / $1,749.00 / $2,883.00
| Facility | | $563.00 | $1,749.00 | $2,883.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.54 / $183.40 / $376.75
| Professional | | $113.54 | $183.40 | $376.75 |