- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $218.78 / $218.78
| Facility | | $134.90 | $218.78 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $194.98 / $346.74
| Professional | | $125.89 | $194.98 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $331.13 / $331.13 / $331.13
| Professional | 50 | $331.13 | $331.13 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,202.26 / $2,951.21
| Facility | | $676.08 | $1,202.26 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,202.26 / $2,137.96 / $5,495.41
| Facility | 50 | $1,202.26 | $2,137.96 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $398.11 / $724.44
| Professional | | $234.42 | $398.11 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $354.81 / $575.44 / $1,047.13
| Professional | 50 | $354.81 | $575.44 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $812.83 / $1,949.84
| Facility | | $562.34 | $812.83 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $575.44 / $954.99
| Professional | | $309.03 | $575.44 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $776.25 / $1,548.82
| Facility | | $630.96 | $776.25 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $512.86 / $870.96
| Professional | | $302.00 | $512.86 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $323.59 / $1,737.80
| Facility | | $186.21 | $323.59 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $457.09 / $1,258.93
| Professional | | $257.04 | $457.09 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,862.09 / $3,388.44
| Facility | | $977.24 | $1,862.09 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $371.54 / $741.31
| Professional | | $190.55 | $371.54 | $741.31 |