- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.62 / $2,818.38 / $10,232.93
| Facility | | $31.62 | $2,818.38 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $120.23 / $501.19 / $812.83
| Facility | 50 | $120.23 | $501.19 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $36.31 / $114.82
| Professional | | $19.05 | $36.31 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $26.92 / $60.26 / $263.03
| Professional | 50 | $26.92 | $60.26 | $263.03 |
- 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
- $19.05 / $46.77 / $104.71
| Professional | | $19.05 | $46.77 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $28.18 / $64.57 / $147.91
| Professional | 50 | $28.18 | $64.57 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.62 / $57.54 / $141.25
| Facility | | $31.62 | $57.54 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $47.86 / $93.33
| Professional | | $20.42 | $47.86 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $1,047.13 / $3,467.37
| Facility | | $186.21 | $1,047.13 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $43.65 / $77.62
| Professional | | $22.91 | $43.65 | $77.62 |