- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.49 / $82.52 / $3,023.85
| Facility | | $55.49 | $82.52 | $3,023.85 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $815.34 / $815.34 / $815.34
| Facility | 50 | $815.34 | $815.34 | $815.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.46 / $82.52 / $195.93
| Professional | | $52.46 | $82.52 | $195.93 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $118.59 / $241.70 / $662.00
| Professional | 50 | $118.59 | $241.70 | $662.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $384.92 / $954.52 / $2,733.75
| Facility | | $384.92 | $954.52 | $2,733.75 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $675.36 / $1,024.66 / $1,796.66
| Facility | 50 | $675.36 | $1,024.66 | $1,796.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.41 / $183.31 / $290.93
| Professional | | $105.41 | $183.31 | $290.93 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $157.26 / $266.02 / $423.30
| Professional | 50 | $157.26 | $266.02 | $423.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.20 / $285.47 / $686.74
| Facility | | $201.20 | $285.47 | $686.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.53 / $200.12 / $349.61
| Professional | | $116.53 | $200.12 | $349.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.91 / $260.99 / $540.74
| Facility | | $182.91 | $260.99 | $540.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.14 / $183.06 / $318.79
| Professional | | $113.14 | $183.06 | $318.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.30 / $113.65 / $250.82
| Facility | | $61.30 | $113.65 | $250.82 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,038.11 / $1,038.11 / $1,038.11
| Facility | 50 | $1,038.11 | $1,038.11 | $1,038.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.32 / $172.36 / $417.12
| Professional | | $89.32 | $172.36 | $417.12 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $210.60 / $387.41 / $623.47
| Professional | 50 | $210.60 | $387.41 | $623.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.00 / $1,438.00 / $2,883.00
| Facility | | $382.00 | $1,438.00 | $2,883.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.03 / $148.19 / $296.38
| Professional | | $85.03 | $148.19 | $296.38 |