- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,754.23 / $10,964.78
| Facility | | $954.99 | $2,754.23 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.98 / $5,011.87 / $7,244.36
| Facility | 50 | $0.98 | $5,011.87 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $181.97 / $758.58
| Professional | | $151.36 | $181.97 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $281.84 / $281.84 / $1,479.11
| Professional | 50 | $281.84 | $281.84 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $512.86
| Professional | | $512.86 | $512.86 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $1,584.89 / $3,162.28
| Facility | | $186.21 | $1,584.89 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.98 / $3,162.28 / $7,244.36
| Facility | 50 | $0.98 | $3,162.28 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $467.74 / $1,071.52
| Professional | | $239.88 | $467.74 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $114.82 / $616.60 / $1,479.11
| Professional | 50 | $114.82 | $616.60 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $660.69 / $933.25
| Professional | | $660.69 | $660.69 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $758.58 / $1,096.48
| Facility | | $208.93 | $758.58 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $151.36 / $512.86
| Professional | | $60.26 | $151.36 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $407.38 / $1,023.29
| Professional | | $407.38 | $407.38 | $1,023.29 |