- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $2,238.72 / $4,570.88
| Facility | | $74.13 | $2,238.72 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $933.25 / $933.25 / $933.25
| Facility | 50 | $933.25 | $933.25 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $75.86 / $213.80
| Professional | | $35.48 | $75.86 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $69.18 / $151.36 / $331.13
| Professional | 50 | $69.18 | $151.36 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $57.54 / $102.33
| Professional | | $38.02 | $57.54 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $69.18
| Professional | | $32.36 | $33.11 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $512.86 / $1,148.15
| Facility | | $436.52 | $512.86 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $645.65 / $758.58 / $1,737.80
| Facility | 50 | $645.65 | $758.58 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $77.62 / $117.49
| Professional | | $48.98 | $77.62 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $77.62 / $120.23
| Professional | | $40.74 | $77.62 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $75.86 / $107.15
| Professional | | $45.71 | $75.86 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $4,466.84 / $5,128.61
| Facility | | $1,071.52 | $4,466.84 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $47.86 / $74.13
| Professional | | $32.36 | $47.86 | $74.13 |