- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $2,511.89 / $9,772.37
| Facility | | $186.21 | $2,511.89 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $977.24 / $4,168.69 / $7,079.46
| Facility | 50 | $977.24 | $4,168.69 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $169.82 / $467.74
| Professional | | $141.25 | $169.82 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $229.09 / $616.60 / $707.95
| Professional | 50 | $229.09 | $616.60 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $323.59 / $331.13 / $524.81
| Professional | 50 | $323.59 | $331.13 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,737.80 / $3,019.95
| Facility | | $1,584.89 | $1,737.80 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $295.12 / $426.58
| Professional | | $144.54 | $295.12 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $218.78 / $446.68 / $645.65
| Professional | 50 | $218.78 | $446.68 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $316.23 / $478.63
| Professional | | $181.97 | $316.23 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $8,709.64 / $8,709.64
| Facility | | $8,709.64 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $263.03 / $457.09
| Professional | | $162.18 | $263.03 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $8,709.64 / $8,709.64
| Facility | | $8,709.64 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $275.42 / $489.78
| Professional | | $177.83 | $275.42 | $489.78 |