- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $154.88 / $3,630.78
| Facility | | $0.98 | $154.88 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,513.56 / $1,513.56 / $1,513.56
| Facility | 50 | $1,513.56 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $223.87 / $512.86
| Professional | | $125.89 | $223.87 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $147.91 / $186.21
| Professional | | $131.83 | $147.91 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $194.98 / $354.81
| Professional | | $131.83 | $194.98 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $173.78 / $239.88
| Professional | | $151.36 | $173.78 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $128.82 / $128.82
| Facility | | $128.82 | $128.82 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $173.78 / $275.42
| Professional | | $123.03 | $173.78 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $194.98 / $218.78
| Professional | | $112.20 | $194.98 | $218.78 |