- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.94 / $593.54 / $2,747.00
| Facility | | $73.94 | $593.54 | $2,747.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $334.51 / $334.51 / $558.72
| Facility | 50 | $334.51 | $334.51 | $558.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.65 / $62.28 / $159.44
| Professional | | $34.65 | $62.28 | $159.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.42 / $627.00 / $2,713.00
| Facility | | $86.42 | $627.00 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.26 / $88.11 / $365.66
| Professional | | $40.26 | $88.11 | $365.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.91 / $53.85 / $96.14
| Facility | | $41.91 | $53.85 | $96.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.48 / $76.84 / $135.52
| Professional | | $53.48 | $76.84 | $135.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.92 / $77.45 / $147.44
| Professional | | $46.92 | $77.45 | $147.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.69 / $108.64 / $6,679.00
| Facility | | $42.69 | $108.64 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.06 / $72.75 / $99.95
| Professional | | $60.06 | $72.75 | $99.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.88 / $98.13 / $150.84
| Professional | | $46.88 | $98.13 | $150.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $187.19 / $343.41 / $563.53
| Facility | | $187.19 | $343.41 | $563.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.77 / $90.55 / $158.33
| Professional | | $47.77 | $90.55 | $158.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.12 / $1,818.00 / $3,445.00
| Facility | | $179.12 | $1,818.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.56 / $113.21 / $632.14
| Professional | | $60.56 | $113.21 | $632.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.03 / $137.75 / $490.78
| Facility | | $27.03 | $137.75 | $490.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.38 / $82.82 / $179.16
| Professional | | $57.38 | $82.82 | $179.16 |