- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,148.15 / $5,128.61
| Facility | | $467.74 | $1,148.15 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,388.44 / $3,388.44 / $3,388.44
| Facility | 50 | $3,388.44 | $3,388.44 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $416.87 / $1,148.15
| Professional | | $190.55 | $416.87 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $281.84 / $812.83 / $1,905.46
| Professional | 50 | $281.84 | $812.83 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,023.29 / $1,023.29
| Facility | | $1,023.29 | $1,023.29 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $389.05 / $741.31
| Professional | | $173.78 | $389.05 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $2,818.38
| Facility | 50 | $2,818.38 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $1,479.11
| Facility | | $1,000.00 | $1,000.00 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $398.11 / $707.95
| Professional | | $218.78 | $398.11 | $707.95 |