- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $1,380.38 / $6,456.54
| Facility | | $407.38 | $1,380.38 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,187.76 / $2,187.76 / $2,187.76
| Facility | 50 | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $52.48 / $123.03
| Professional | | $30.20 | $52.48 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.55 / $27.54 / $46.77
| Professional | | $24.55 | $27.54 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $64.57 / $107.15
| Professional | | $32.36 | $64.57 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $52.48
| Facility | | $45.71 | $45.71 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $53.70 / $117.49
| Professional | | $34.67 | $53.70 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $89.13 / $1,584.89
| Facility | | $34.67 | $89.13 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $85.11 / $1,659.59
| Professional | | $40.74 | $85.11 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $630.96 / $1,659.59
| Facility | | $138.04 | $630.96 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $50.12 / $102.33
| Professional | | $31.62 | $50.12 | $102.33 |