- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $891.25 / $5,888.44
| Facility | | $61.66 | $891.25 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $354.81 / $1,071.52 / $5,248.07
| Facility | 50 | $354.81 | $1,071.52 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $67.61 / $181.97
| Professional | | $36.31 | $67.61 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $3,715.35 / $9,332.54
| Facility | | $1,513.56 | $3,715.35 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $57.54 / $112.20
| Professional | | $35.48 | $57.54 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $87.10 / $389.05
| Facility | | $34.67 | $87.10 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $66.07 / $138.04
| Professional | | $39.81 | $66.07 | $138.04 |
- 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
- $33.88 / $54.95 / $102.33
| Professional | | $33.88 | $54.95 | $102.33 |