- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $2,754.23 / $9,332.54
| Facility | | $95.50 | $2,754.23 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $616.60 / $2,290.87 / $12,882.50
| Facility | 50 | $616.60 | $2,290.87 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $112.20 / $331.13
| Professional | | $56.23 | $112.20 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $141.25 / $338.84 / $1,071.52
| Professional | 50 | $141.25 | $338.84 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $3,715.35 / $9,549.93
| Facility | | $1,513.56 | $3,715.35 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $91.20 / $173.78
| Professional | | $58.88 | $91.20 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $95.50 / $138.04 / $257.04
| Professional | 50 | $95.50 | $138.04 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $331.13 / $870.96
| Facility | | $64.57 | $331.13 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $123.03 / $281.84
| Professional | | $67.61 | $123.03 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,949.84 / $4,786.30
| Facility | | $562.34 | $1,949.84 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $91.20 / $190.55
| Professional | | $52.48 | $91.20 | $190.55 |