- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,511.89 / $4,786.30
| Facility | | $660.69 | $2,511.89 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $954.99 / $3,162.28 / $4,365.16
| Facility | 50 | $954.99 | $3,162.28 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $169.82 / $812.83
| Professional | | $141.25 | $169.82 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $251.19 / $645.65 / $1,230.27
| Professional | 50 | $251.19 | $645.65 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,467.37 / $5,754.40
| Facility | | $1,047.13 | $3,467.37 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,995.26 / $5,495.41 / $10,232.93
| Facility | 50 | $1,995.26 | $5,495.41 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $363.08 / $588.84
| Professional | | $239.88 | $363.08 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $363.08 / $524.81 / $870.96
| Professional | 50 | $363.08 | $524.81 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $588.84 / $1,412.54
| Facility | | $416.87 | $588.84 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $501.19 / $758.58
| Professional | | $331.13 | $501.19 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $660.69 / $1,122.02
| Facility | | $457.09 | $660.69 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $426.58 / $645.65
| Professional | | $302.00 | $426.58 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $1,230.27 / $4,897.79
| Facility | | $229.09 | $1,230.27 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $891.25 / $2,454.71 / $4,073.80
| Facility | 50 | $891.25 | $2,454.71 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $323.59 / $912.01
| Professional | | $190.55 | $323.59 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,548.13 / $6,456.54
| Facility | | $1,584.89 | $3,548.13 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $323.59 / $630.96
| Professional | | $190.55 | $323.59 | $630.96 |