- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.86 / $4,554.68 / $10,122.27
| Facility | | $325.86 | $4,554.68 | $10,122.27 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $825.48 / $2,063.46 / $6,239.89
| Facility | 50 | $825.48 | $2,063.46 | $6,239.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.39 / $325.86 / $422.90
| Professional | | $291.39 | $325.86 | $422.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.16 / $351.07 / $503.60
| Professional | | $319.16 | $351.07 | $503.60 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $478.74 / $526.61 / $755.40
| Professional | 50 | $478.74 | $526.61 | $755.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.72 / $432.70 / $568.45
| Professional | | $326.72 | $432.70 | $568.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.64 / $378.19 / $580.16
| Professional | | $293.64 | $378.19 | $580.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.86 / $6,385.49 / $10,122.27
| Facility | | $325.86 | $6,385.49 | $10,122.27 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.40 / $2,063.46 / $19,850.86
| Facility | 50 | $0.40 | $2,063.46 | $19,850.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.06 / $325.86 / $487.59
| Professional | | $290.06 | $325.86 | $487.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.87 / $448.92 / $541.79
| Professional | | $352.87 | $448.92 | $541.79 |