- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $1,288.25 / $3,715.35
| Facility | | $295.12 | $1,288.25 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $123.03 / $218.78
| Professional | | $60.26 | $123.03 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $134.90 / $134.90 / $208.93
| Professional | 50 | $134.90 | $134.90 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $70.79
| Professional | | $60.26 | $60.26 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $851.14 / $1,862.09
| Facility | | $346.74 | $851.14 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $128.82 / $239.88
| Professional | | $72.44 | $128.82 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $501.19 / $501.19
| Facility | | $39.81 | $501.19 | $501.19 |
- 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
- $69.18 / $120.23 / $229.09
| Professional | | $69.18 | $120.23 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $1,096.48 / $2,344.23
| Facility | | $338.84 | $1,096.48 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $120.23 / $229.09
| Professional | | $56.23 | $120.23 | $229.09 |