- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $2,691.53 / $8,511.38
| Facility | | $93.33 | $2,691.53 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $616.60 / $1,479.11 / $5,623.41
| Facility | 50 | $616.60 | $1,479.11 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $75.86 / $162.18
| Professional | | $46.77 | $75.86 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $109.65 / $218.78 / $275.42
| Professional | 50 | $109.65 | $218.78 | $275.42 |
- 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
- $47.86 / $79.43 / $169.82
| Professional | | $47.86 | $79.43 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $69.18 / $112.20 / $234.42
| Professional | 50 | $69.18 | $112.20 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $109.65 / $416.87
| Facility | | $34.67 | $109.65 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $91.20 / $186.21
| Professional | | $46.77 | $91.20 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $1,071.52 / $3,467.37
| Facility | | $229.09 | $1,071.52 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $77.62 / $144.54
| Professional | | $50.12 | $77.62 | $144.54 |