- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $2,511.89 / $4,897.79
| Facility | | $257.04 | $2,511.89 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $870.96 / $2,570.40 / $4,897.79
| Facility | 50 | $870.96 | $2,570.40 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $208.93 / $812.83
| Professional | | $138.04 | $208.93 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $239.88 / $512.86 / $1,230.27
| Professional | 50 | $239.88 | $512.86 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $3,162.28 / $45,708.82
| Facility | | $398.11 | $3,162.28 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $239.88 / $1,445.44
| Professional | | $128.82 | $239.88 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $331.13
| Professional | | $331.13 | $331.13 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $316.23 / $602.56
| Professional | | $181.97 | $316.23 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $575.44 / $7,079.46
| Facility | | $151.36 | $575.44 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $213.80 / $371.54
| Professional | | $169.82 | $213.80 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,630.78 / $8,511.38
| Facility | | $1,698.24 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $281.84 / $457.09
| Professional | | $158.49 | $281.84 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,951.21 / $3,981.07
| Facility | | $954.99 | $2,951.21 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $151.36 / $416.87
| Professional | | $144.54 | $151.36 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $3,548.13 / $45,708.82
| Facility | | $398.11 | $3,548.13 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $234.42 / $1,445.44
| Professional | | $128.82 | $234.42 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,630.78 / $8,511.38
| Facility | | $1,584.89 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $269.15 / $549.54
| Professional | | $173.78 | $269.15 | $549.54 |