- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $3,019.95 / $5,888.44
| Facility | | $239.88 | $3,019.95 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $575.44 / $660.69 / $6,606.93
| Facility | 50 | $575.44 | $660.69 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $107.15 / $537.03
| Professional | | $48.98 | $107.15 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $72.44 / $147.91 / $512.86
| Professional | 50 | $72.44 | $147.91 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $87.10 / $151.36
| Professional | | $56.23 | $87.10 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $102.33
| Professional | | $32.36 | $33.11 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $147.91 / $234.42
| Professional | | $83.18 | $147.91 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $102.33 / $190.55
| Professional | | $57.54 | $102.33 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $131.83 / $177.83
| Professional | | $70.79 | $131.83 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $4,466.84 / $5,128.61
| Facility | | $1,071.52 | $4,466.84 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $79.43 / $128.82
| Professional | | $45.71 | $79.43 | $128.82 |