- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $2,041.74 / $7,762.47
| Facility | | $85.11 | $2,041.74 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.56 / $707.95 / $2,754.23
| Facility | 50 | $0.56 | $707.95 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $85.11 / $245.47
| Professional | | $43.65 | $85.11 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $114.82 / $239.88 / $380.19
| Professional | 50 | $114.82 | $239.88 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $3,715.35 / $9,549.93
| Facility | | $1,513.56 | $3,715.35 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $81.28 / $158.49
| Professional | | $44.67 | $81.28 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $64.57 / $117.49 / $234.42
| Professional | 50 | $64.57 | $117.49 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.86 / $234.42 / $741.31
| Facility | | $47.86 | $234.42 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $91.20 / $194.98
| Professional | | $51.29 | $91.20 | $194.98 |
- 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
- $42.66 / $74.13 / $141.25
| Professional | | $42.66 | $74.13 | $141.25 |