- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $2,951.21 / $5,370.32
| Facility | | $165.96 | $2,951.21 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $933.25 / $933.25 / $2,818.38
| Facility | 50 | $933.25 | $933.25 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $131.83 / $363.08
| Professional | | $57.54 | $131.83 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $323.59 / $831.76 / $831.76
| Professional | 50 | $323.59 | $831.76 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $102.33 / $199.53
| Professional | | $64.57 | $102.33 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $223.87
| Professional | | $32.36 | $33.11 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,230.27 / $2,754.23
| Facility | | $1,047.13 | $1,230.27 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,584.89 / $1,862.09 / $4,073.80
| Facility | 50 | $1,584.89 | $1,862.09 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $173.78 / $295.12
| Professional | | $93.33 | $173.78 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $134.90 / $275.42
| Professional | | $72.44 | $134.90 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $169.82 / $229.09
| Professional | | $89.13 | $169.82 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,818.38 / $5,128.61
| Facility | | $1,096.48 | $2,818.38 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $87.10 / $151.36
| Professional | | $54.95 | $87.10 | $151.36 |