- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.57 / $871.26 / $1,958.83
| Facility | | $279.57 | $871.26 | $1,958.83 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,281.29 / $1,281.29 / $2,446.84
| Facility | 50 | $1,281.29 | $1,281.29 | $2,446.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.09 / $207.53 / $320.98
| Professional | | $95.09 | $207.53 | $320.98 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $2,244.54 / $2,244.54 / $2,244.54
| Professional | 50 | $2,244.54 | $2,244.54 | $2,244.54 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $20.85 / $26.38 / $55.92
| Professional | 53 | $20.85 | $26.38 | $55.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.78 / $143.27 / $218.23
| Professional | | $121.78 | $143.27 | $218.23 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $182.67 / $214.91 / $327.33
| Professional | 50 | $182.67 | $214.91 | $327.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.56 / $243.89 / $524.28
| Professional | | $138.56 | $243.89 | $524.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.26 / $300.91 / $483.08
| Professional | | $137.26 | $300.91 | $483.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.57 / $1,268.82 / $1,830.69
| Facility | | $279.57 | $1,268.82 | $1,830.69 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,151.92 / $1,424.49 / $2,446.84
| Facility | 50 | $1,151.92 | $1,424.49 | $2,446.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.96 / $217.18 / $384.24
| Professional | | $108.96 | $217.18 | $384.24 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $2,244.54 / $2,244.54 / $2,244.54
| Professional | 50 | $2,244.54 | $2,244.54 | $2,244.54 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $20.85 / $29.96 / $55.92
| Professional | 53 | $20.85 | $29.96 | $55.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $201.90 / $304.14 / $502.64
| Professional | | $201.90 | $304.14 | $502.64 |