- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $1,819.70 / $9,772.37
| Facility | | $323.59 | $1,819.70 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $114.82 / $229.09
| Professional | | $61.66 | $114.82 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $158.49 / $158.49 / $162.18
| Professional | 50 | $158.49 | $158.49 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,412.54 / $2,630.27
| Facility | | $1,288.25 | $1,412.54 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $107.15 / $151.36
| Professional | | $48.98 | $107.15 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $72.44 / $162.18 / $229.09
| Professional | 50 | $72.44 | $162.18 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,348.96 / $1,348.96
| Facility | | $1,348.96 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $138.04 / $263.03
| Professional | | $72.44 | $138.04 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $7,943.28 / $7,943.28
| Facility | | $7,943.28 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $114.82 / $223.87
| Professional | | $60.26 | $114.82 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $7,943.28 / $7,943.28
| Facility | | $7,943.28 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $123.03 / $245.47
| Professional | | $63.10 | $123.03 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $75.86 / $120.23
| Facility | | $75.86 | $75.86 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $114.82 / $114.82 / $114.82
| Facility | 50 | $114.82 | $114.82 | $114.82 |