- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $7,762.47 / $9,772.37
| Facility | | $234.42 | $7,762.47 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $204.17 / $512.86
| Professional | | $125.89 | $204.17 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $1,584.89 / $1,584.89 / $1,584.89
| Professional | 50 | $1,584.89 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $147.91 / $309.03
| Professional | | $112.20 | $147.91 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,981.07 / $7,079.46
| Facility | | $2,290.87 | $3,981.07 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $165.96 / $263.03
| Professional | | $112.20 | $165.96 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $194.98 / $251.19
| Facility | | $194.98 | $194.98 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $234.42 / $389.05
| Professional | | $144.54 | $234.42 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $234.42 / $446.68
| Facility | | $141.25 | $234.42 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,230.27 / $3,548.13
| Facility | | $380.19 | $1,230.27 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $204.17 / $354.81
| Professional | | $128.82 | $204.17 | $354.81 |