- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $977.24 / $6,606.93
| Facility | | $107.15 | $977.24 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.58 / $977.24 / $5,248.07
| Facility | 50 | $0.58 | $977.24 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $112.20 / $302.00
| Professional | | $51.29 | $112.20 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $54.95 / $346.74 / $831.76
| Professional | 50 | $54.95 | $346.74 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $3,715.35 / $9,332.54
| Facility | | $1,513.56 | $3,715.35 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $89.13 / $177.83
| Professional | | $51.29 | $89.13 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $77.62 / $134.90 / $257.04
| Professional | 50 | $77.62 | $134.90 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $186.21 / $831.76
| Facility | | $74.13 | $186.21 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $128.82 / $275.42
| Professional | | $61.66 | $128.82 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $1,071.52 / $3,467.37
| Facility | | $234.42 | $1,071.52 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $100.00 / $204.17
| Professional | | $50.12 | $100.00 | $204.17 |