- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $2,238.72 / $3,801.89
| Facility | | $245.47 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $2,818.38
| Facility | 50 | $2,818.38 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $213.80 / $446.68
| Professional | | $141.25 | $213.80 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $100.00 / $407.38 / $1,258.93
| Professional | 50 | $100.00 | $407.38 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $1,000.00 / $19,498.45
| Facility | | $302.00 | $1,000.00 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $229.09 / $512.86
| Professional | | $123.03 | $229.09 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $346.74
| Facility | | $151.36 | $151.36 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $263.03 / $371.54
| Professional | | $151.36 | $263.03 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $269.15 / $316.23 / $316.23
| Professional | 50 | $269.15 | $316.23 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $208.93 / $208.93
| Facility | | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $275.42 / $489.78
| Professional | | $162.18 | $275.42 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $218.78 / $7,079.46
| Facility | | $114.82 | $218.78 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $223.87 / $316.23
| Professional | | $169.82 | $223.87 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,862.09 / $3,467.37
| Facility | | $501.19 | $1,862.09 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $218.78 / $426.58
| Professional | | $134.90 | $218.78 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $234.42 / $398.11
| Professional | | $229.09 | $234.42 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $1,023.29 / $19,498.45
| Facility | | $302.00 | $1,023.29 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $229.09 / $501.19
| Professional | | $123.03 | $229.09 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $239.88 / $426.58
| Professional | | $144.54 | $239.88 | $426.58 |