- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $891.25 / $7,762.47
| Facility | | $138.04 | $891.25 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $1,000.00
| Facility | 50 | $1,000.00 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $100.00 / $239.88
| Professional | | $50.12 | $100.00 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $69.18 / $125.89
| Professional | | $45.71 | $69.18 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $645.65 / $1,148.15
| Facility | | $323.59 | $645.65 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $128.82 / $199.53
| Professional | | $56.23 | $128.82 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $346.74 / $501.19
| Facility | | $346.74 | $346.74 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $91.20 / $165.96
| Professional | | $56.23 | $91.20 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $138.04 / $138.04
| Professional | | $138.04 | $138.04 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $100.00 / $162.18
| Facility | | $58.88 | $100.00 | $162.18 |
- 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
- $47.86 / $81.28 / $154.88
| Professional | | $47.86 | $81.28 | $154.88 |