- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $831.76 / $5,888.44
| Facility | | $63.10 | $831.76 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $275.42 / $707.95 / $1,621.81
| Facility | 50 | $275.42 | $707.95 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $79.43 / $251.19
| Professional | | $40.74 | $79.43 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $72.44 / $128.82 / $338.84
| Professional | 50 | $72.44 | $128.82 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,715.35 / $9,332.54
| Facility | | $1,380.38 | $3,715.35 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $61.66 / $123.03
| Professional | | $36.31 | $61.66 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $51.29 / $89.13 / $177.83
| Professional | 50 | $51.29 | $89.13 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $165.96 / $512.86
| Facility | | $34.67 | $165.96 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $69.18 / $147.91
| Professional | | $42.66 | $69.18 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $1,071.52 / $3,467.37
| Facility | | $234.42 | $1,071.52 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $56.23 / $104.71
| Professional | | $36.31 | $56.23 | $104.71 |