- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $3,388.44 / $10,715.19
| Facility | | $52.48 | $3,388.44 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.15 / $53.70 / $128.82
| Professional | | $37.15 | $53.70 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $53.70 / $87.10 / $123.03
| Professional | 50 | $53.70 | $87.10 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $3,890.45 / $9,549.93
| Facility | | $1,621.81 | $3,890.45 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $60.26 / $125.89
| Professional | | $35.48 | $60.26 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $52.48 / $85.11 / $173.78
| Professional | 50 | $52.48 | $85.11 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $120.23 / $338.84
| Facility | | $50.12 | $120.23 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $66.07 / $134.90
| Professional | | $36.31 | $66.07 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $1,122.02 / $3,467.37
| Facility | | $263.03 | $1,122.02 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $54.95 / $100.00
| Professional | | $35.48 | $54.95 | $100.00 |