- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $3,019.95 / $4,570.88
| Facility | | $147.91 | $3,019.95 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $602.56 / $691.83 / $1,698.24
| Facility | 50 | $602.56 | $691.83 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $181.97 / $467.74
| Professional | | $112.20 | $181.97 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $151.36 / $436.52 / $524.81
| Professional | 50 | $151.36 | $436.52 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $181.97 / $257.04
| Professional | | $109.65 | $181.97 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $204.17
| Professional | | $32.36 | $33.11 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $512.86 / $1,122.02
| Facility | | $436.52 | $512.86 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $645.65 / $758.58 / $1,698.24
| Facility | 50 | $645.65 | $758.58 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $234.42 / $302.00
| Professional | | $165.96 | $234.42 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $199.53 / $295.12
| Professional | | $131.83 | $199.53 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $173.78 / $245.47
| Professional | | $87.10 | $173.78 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $4,466.84 / $5,128.61
| Facility | | $1,071.52 | $4,466.84 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $138.04 / $213.80
| Professional | | $104.71 | $138.04 | $213.80 |