- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $81.28 / $3,090.30
| Facility | | $54.95 | $81.28 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $812.83 / $812.83 / $812.83
| Facility | 50 | $812.83 | $812.83 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.70 / $91.20 / $316.23
| Professional | | $53.70 | $91.20 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $112.20 / $213.80 / $645.65
| Professional | 50 | $112.20 | $213.80 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,071.52 / $2,454.71
| Facility | | $467.74 | $1,071.52 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $691.83 / $1,258.93 / $3,162.28
| Facility | 50 | $691.83 | $1,258.93 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $158.49 / $281.84
| Professional | | $97.72 | $158.49 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $144.54 / $234.42 / $389.05
| Professional | 50 | $144.54 | $234.42 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $302.00 / $724.44
| Facility | | $213.80 | $302.00 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $194.98 / $346.74
| Professional | | $117.49 | $194.98 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $288.40 / $562.34
| Facility | | $234.42 | $288.40 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $181.97 / $331.13
| Professional | | $120.23 | $181.97 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $117.49 / $758.58
| Facility | | $60.26 | $117.49 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,047.13 / $1,047.13 / $1,047.13
| Facility | 50 | $1,047.13 | $1,047.13 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $181.97 / $426.58
| Professional | | $83.18 | $181.97 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $208.93 / $389.05 / $645.65
| Professional | 50 | $208.93 | $389.05 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $1,819.70 / $3,467.37
| Facility | | $602.56 | $1,819.70 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $120.23 / $239.88
| Professional | | $66.07 | $120.23 | $239.88 |