- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $171.43 / $2,999.70 / $15,062.16
| Facility | | $171.43 | $2,999.70 | $15,062.16 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,647.66 / $4,410.13 / $8,421.54
| Facility | 50 | $2,647.66 | $4,410.13 | $8,421.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.41 / $147.75 / $171.43
| Professional | | $139.41 | $147.75 | $171.43 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $128.66 / $128.66 / $280.54
| Professional | 50 | $128.66 | $128.66 | $280.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.41 / $203.49 / $285.49
| Professional | | $147.41 | $203.49 | $285.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,710.47 / $2,026.37 / $5,443.99
| Facility | | $1,710.47 | $2,026.37 | $5,443.99 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,829.62 / $4,084.64 / $5,332.15
| Facility | 50 | $2,829.62 | $4,084.64 | $5,332.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.81 / $212.29 / $354.75
| Professional | | $155.81 | $212.29 | $354.75 |