- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $1,412.54 / $4,073.80
| Facility | | $257.04 | $1,412.54 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $512.86 / $512.86 / $512.86
| Facility | 50 | $512.86 | $512.86 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $204.17 / $562.34
| Professional | | $63.10 | $204.17 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $165.96 / $275.42 / $1,148.15
| Professional | 50 | $165.96 | $275.42 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $213.80 / $416.87
| Professional | | $81.28 | $213.80 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $165.96
| Professional | | $32.36 | $33.11 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $199.53 / $436.52
| Professional | | $91.20 | $199.53 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $218.78 / $467.74
| Professional | | $112.20 | $218.78 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $316.23 / $478.63
| Professional | | $93.33 | $316.23 | $478.63 |
- 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
- $67.61 / $169.82 / $309.03
| Professional | | $67.61 | $169.82 | $309.03 |