- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $162.18 / $1,258.93
| Facility | | $61.66 | $162.18 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $114.82 / $263.03
| Professional | | $60.26 | $114.82 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $134.90 / $208.93 / $208.93
| Professional | 50 | $134.90 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $3,162.28 / $6,309.57
| Facility | | $1,412.54 | $3,162.28 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,089.30 / $3,715.35 / $9,549.93
| Facility | 50 | $2,089.30 | $3,715.35 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $234.42 / $512.86
| Professional | | $117.49 | $234.42 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $173.78 / $346.74 / $741.31
| Professional | 50 | $173.78 | $346.74 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $602.56 / $1,445.44
| Facility | | $380.19 | $602.56 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $288.40 / $691.83
| Professional | | $134.90 | $288.40 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $575.44 / $1,122.02
| Facility | | $467.74 | $575.44 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $269.15 / $602.56
| Professional | | $138.04 | $269.15 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $177.83 / $1,148.15
| Facility | | $70.79 | $177.83 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $251.19 / $776.25
| Professional | | $134.90 | $251.19 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $2,238.72 / $5,495.41
| Facility | | $1,174.90 | $2,238.72 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $173.78 / $426.58
| Professional | | $79.43 | $173.78 | $426.58 |