- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.28 / $509.60 / $2,382.75
| Facility | | $123.28 | $509.60 | $2,382.75 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $478.20 / $706.14 / $796.62
| Facility | 50 | $478.20 | $706.14 | $796.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.65 / $97.94 / $185.01
| Professional | | $50.65 | $97.94 | $185.01 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $83.28 / $249.86 / $657.00
| Professional | 50 | $83.28 | $249.86 | $657.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.37 / $54.37 / $54.52
| Facility | | $54.37 | $54.37 | $54.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.94 / $87.05 / $134.55
| Professional | | $53.94 | $87.05 | $134.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.23 / $113.31 / $212.76
| Facility | | $42.23 | $113.31 | $212.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.18 / $118.49 / $157.40
| Professional | | $66.18 | $118.49 | $157.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $116.24 / $152.00
| Professional | | $32.34 | $116.24 | $152.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $965.45 / $1,753.89 / $2,148.87
| Facility | | $965.45 | $1,753.89 | $2,148.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,313.42 / $2,630.84 / $3,267.48
| Facility | 50 | $1,313.42 | $2,630.84 | $3,267.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.81 / $99.12 / $154.44
| Professional | | $70.81 | $99.12 | $154.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.00 / $2,620.00 / $4,441.00
| Facility | | $450.00 | $2,620.00 | $4,441.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.26 / $130.19 / $186.01
| Professional | | $86.26 | $130.19 | $186.01 |