- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.50 / $976.82 / $9,077.87
| Facility | | $115.50 | $976.82 | $9,077.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $5,687.44 / $5,687.44 / $5,687.44
| Facility | 50 | $5,687.44 | $5,687.44 | $5,687.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.31 / $76.42 / $129.53
| Professional | | $40.31 | $76.42 | $129.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.06 / $69.94 / $149.46
| Professional | | $45.06 | $69.94 | $149.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $798.78 / $1,101.72 / $1,585.50
| Facility | | $798.78 | $1,101.72 | $1,585.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.40 / $51.40 / $51.40
| Professional | | $51.40 | $51.40 | $51.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.50 / $103.07 / $288.22
| Professional | | $66.50 | $103.07 | $288.22 |