- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $501.19 / $501.19
| Facility | | $389.05 | $501.19 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $467.74 / $812.83
| Professional | | $354.81 | $467.74 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $5,128.61 / $10,715.19
| Facility | | $2,187.76 | $5,128.61 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,495.41 / $9,772.37 / $25,118.86
| Facility | 50 | $5,495.41 | $9,772.37 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $912.01 / $1,513.56
| Professional | | $602.56 | $912.01 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,737.80 / $4,168.69
| Facility | | $1,230.27 | $1,737.80 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $1,230.27 / $1,995.26
| Professional | | $741.31 | $1,230.27 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,659.59 / $3,311.31
| Facility | | $1,348.96 | $1,659.59 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $1,174.90 / $1,862.09
| Professional | | $776.25 | $1,174.90 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $707.95 / $1,412.54
| Facility | | $407.38 | $707.95 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $851.14 / $2,754.23
| Professional | | $457.09 | $851.14 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $5,248.07 / $8,912.51
| Facility | | $1,584.89 | $5,248.07 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $741.31 / $1,479.11
| Professional | | $436.52 | $741.31 | $1,479.11 |