- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $2,137.96 / $6,760.83
| Facility | | $194.98 | $2,137.96 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $851.14 / $2,570.40 / $7,413.10
| Facility | 50 | $851.14 | $2,570.40 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $138.04 / $389.05
| Professional | | $70.79 | $138.04 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $4,168.69 / $10,000.00
| Facility | | $1,548.82 | $4,168.69 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $158.49 / $302.00
| Professional | | $83.18 | $158.49 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $537.03 / $1,318.26
| Facility | | $125.89 | $537.03 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $165.96 / $407.38
| Professional | | $87.10 | $165.96 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,884.03 / $6,309.57
| Facility | | $1,000.00 | $2,884.03 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $125.89 / $251.19
| Professional | | $70.79 | $125.89 | $251.19 |