- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $2,187.76 / $3,801.89
| Facility | | $128.82 | $2,187.76 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $323.59 / $323.59 / $323.59
| Facility | 50 | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $154.88 / $371.54
| Professional | | $112.20 | $154.88 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $162.18 / $331.13 / $1,047.13
| Professional | 50 | $162.18 | $331.13 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $630.96 / $2,754.23
| Facility | | $56.23 | $630.96 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $165.96 / $426.58
| Professional | | $102.33 | $165.96 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $141.25 / $323.59
| Facility | | $141.25 | $141.25 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $239.88 / $346.74
| Professional | | $141.25 | $239.88 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $213.80 / $316.23 / $316.23
| Professional | 50 | $213.80 | $316.23 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $109.65
| Facility | | $50.12 | $50.12 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $234.42 / $416.87
| Professional | | $112.20 | $234.42 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $218.78 / $7,079.46
| Facility | | $107.15 | $218.78 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $186.21 / $263.03
| Professional | | $141.25 | $186.21 | $263.03 |
- 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
- $125.89 / $190.55 / $363.08
| Professional | | $125.89 | $190.55 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $213.80 / $269.15
| Professional | | $85.11 | $213.80 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $691.83 / $2,818.38
| Facility | | $56.23 | $691.83 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $165.96 / $426.58
| Professional | | $102.33 | $165.96 | $426.58 |
- 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
- $117.49 / $165.96 / $363.08
| Professional | | $117.49 | $165.96 | $363.08 |