- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $1,778.28 / $3,311.31
| Facility | | $0.98 | $1,778.28 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $288.40 / $1,174.90 / $1,174.90
| Facility | 50 | $288.40 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $1,318.26 / $4,570.88
| Professional | | $436.52 | $1,318.26 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $407.38 / $489.78
| Professional | | $371.54 | $407.38 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $8,317.64 / $8,317.64
| Facility | | $8,317.64 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $1,174.90 / $3,548.13
| Professional | | $389.05 | $1,174.90 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,949.84 / $3,715.35
| Professional | | $1,479.11 | $1,949.84 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $3,548.13 / $3,548.13
| Facility | | $3,548.13 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $1,584.89 / $3,890.45
| Professional | | $380.19 | $1,584.89 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,659.59 / $1,949.84 / $2,818.38
| Professional | | $1,659.59 | $1,949.84 | $2,818.38 |