- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $1,148.15 / $4,466.84
| Facility | | $316.23 | $1,148.15 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $575.44 / $3,090.30 / $10,232.93
| Facility | 50 | $575.44 | $3,090.30 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $316.23 / $501.19
| Professional | | $177.83 | $316.23 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $117.49 / $346.74 / $630.96
| Professional | 50 | $117.49 | $346.74 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $169.82 / $489.78
| Professional | | $169.82 | $169.82 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $114.82 / $147.91 / $251.19
| Professional | 50 | $114.82 | $147.91 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $4,677.35 / $6,918.31
| Facility | | $2,089.30 | $4,677.35 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $316.23 / $457.09
| Professional | | $194.98 | $316.23 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $2,630.27 / $2,630.27
| Facility | | $39.81 | $2,630.27 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $309.03 / $512.86
| Professional | | $190.55 | $309.03 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,630.27 / $6,606.93
| Facility | | $831.76 | $2,630.27 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $316.23 / $616.60
| Professional | | $173.78 | $316.23 | $616.60 |