- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $1,288.25 / $3,715.35
| Facility | | $316.23 | $1,288.25 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,981.07 / $3,981.07 / $9,120.11
| Facility | 50 | $3,981.07 | $3,981.07 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $208.93 / $407.38 / $977.24
| Professional | 50 | $208.93 | $407.38 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $147.91 / $190.55 / $204.17
| Professional | 50 | $147.91 | $190.55 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.87 / $2.04
| Facility | | $0.02 | $0.87 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $39.81 / $104.71
| Facility | | $39.81 | $39.81 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $512.86 / $1,258.93
| Facility | | $199.53 | $512.86 | $1,258.93 |