- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $3,467.37 / $7,943.28
| Facility | | $89.13 | $3,467.37 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $501.19 / $2,454.71 / $2,454.71
| Facility | 50 | $501.19 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $85.11 / $158.49
| Professional | | $51.29 | $85.11 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $117.49 / $181.97 / $346.74
| Professional | 50 | $117.49 | $181.97 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $70.79 / $93.33
| Professional | | $35.48 | $70.79 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $45.71 / $89.13 / $162.18
| Professional | 50 | $45.71 | $89.13 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $371.54 / $371.54
| Facility | | $346.74 | $371.54 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $83.18 / $109.65
| Professional | | $83.18 | $83.18 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $331.13
| Facility | | $331.13 | $331.13 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $91.20 / $138.04
| Professional | | $63.10 | $91.20 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.54 / $102.33 / $478.63
| Facility | | $57.54 | $102.33 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $114.82 / $616.60
| Professional | | $79.43 | $114.82 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $147.91 / $147.91 / $147.91
| Professional | 50 | $147.91 | $147.91 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $416.87 / $1,778.28
| Facility | | $218.78 | $416.87 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $83.18 / $123.03
| Professional | | $60.26 | $83.18 | $123.03 |