- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.47 / $1,493.16 / $3,392.99
| Facility | | $129.47 | $1,493.16 | $3,392.99 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,803.42 / $2,803.42 / $2,803.42
| Facility | 50 | $2,803.42 | $2,803.42 | $2,803.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.68 / $128.33 / $226.88
| Professional | | $72.68 | $128.33 | $226.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.52 / $166.58 / $270.63
| Professional | | $86.52 | $166.58 | $270.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.12 / $184.31 / $332.41
| Professional | | $104.12 | $184.31 | $332.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.11 / $190.70 / $330.31
| Professional | | $105.11 | $190.70 | $330.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.78 / $1,875.45 / $3,839.47
| Facility | | $1,154.78 | $1,875.45 | $3,839.47 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,803.42 / $2,803.42 / $2,803.42
| Facility | 50 | $2,803.42 | $2,803.42 | $2,803.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.04 / $129.47 / $271.58
| Professional | | $73.04 | $129.47 | $271.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.80 / $190.88 / $352.88
| Professional | | $128.80 | $190.88 | $352.88 |