- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $602.56 / $1,023.29
| Facility | | $295.12 | $602.56 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $1,122.02
| Facility | 50 | $1,000.00 | $1,000.00 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $91.20 / $208.93
| Professional | | $48.98 | $91.20 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $74.13 / $141.25 / $302.00
| Professional | 50 | $74.13 | $141.25 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $199.53 / $295.12
| Professional | | $123.03 | $199.53 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $102.33 / $186.21 / $446.68
| Professional | 50 | $102.33 | $186.21 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $117.49 / $218.78
| Professional | | $70.79 | $117.49 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $3,090.30
| Facility | | $295.12 | $295.12 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $131.83 / $275.42
| Professional | | $64.57 | $131.83 | $275.42 |