- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $1,288.25 / $3,890.45
| Facility | | $295.12 | $1,288.25 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $81.28 / $147.91
| Professional | | $42.66 | $81.28 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $275.42 / $331.13 / $338.84
| Professional | 50 | $275.42 | $331.13 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $426.58 / $645.65
| Facility | | $162.18 | $426.58 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $87.10 / $125.89
| Professional | | $54.95 | $87.10 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.02 / $39.81 / $39.81
| Facility | | $38.02 | $39.81 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $426.58 / $426.58
| Facility | | $426.58 | $426.58 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $97.72 / $181.97
| Professional | | $50.12 | $97.72 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $501.19 / $1,202.26
| Facility | | $213.80 | $501.19 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $75.86 / $151.36
| Professional | | $40.74 | $75.86 | $151.36 |