- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.62 / $208.93 / $7,244.36
| Facility | | $31.62 | $208.93 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,398.83 / $2,398.83 / $2,398.83
| Facility | 50 | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $52.48 / $97.72
| Professional | | $30.20 | $52.48 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $51.29 / $120.23
| Professional | | $28.84 | $51.29 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $3,890.45 / $3,890.45
| Facility | | $3,890.45 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $501.19
| Facility | | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $57.54 / $117.49
| Professional | | $30.20 | $57.54 | $117.49 |