- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $2,754.23 / $9,120.11
| Facility | | $173.78 | $2,754.23 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $912.01 / $4,168.69 / $8,912.51
| Facility | 50 | $912.01 | $4,168.69 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $190.55 / $457.09
| Professional | | $138.04 | $190.55 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $234.42 / $489.78 / $707.95
| Professional | 50 | $234.42 | $489.78 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $151.36 / $537.03
| Professional | | $75.86 | $151.36 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $128.82 / $229.09 / $380.19
| Professional | 50 | $128.82 | $229.09 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $660.69 / $2,290.87
| Facility | | $269.15 | $660.69 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $213.80 / $398.11
| Professional | | $138.04 | $213.80 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $4,786.30 / $9,549.93
| Facility | | $2,691.53 | $4,786.30 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $109.65 / $162.18
| Professional | | $102.33 | $109.65 | $162.18 |
- 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
- $933.25 / $3,548.13 / $6,760.83
| Facility | | $933.25 | $3,548.13 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $186.21 / $323.59
| Professional | | $128.82 | $186.21 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $123.03 / $144.54
| Professional | | $123.03 | $123.03 | $144.54 |