- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.52 / $521.50 / $4,375.00
| Facility | | $103.52 | $521.50 | $4,375.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $346.07 / $346.07 / $346.07
| Facility | 50 | $346.07 | $346.07 | $346.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.99 / $55.13 / $99.66
| Professional | | $33.99 | $55.13 | $99.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.89 / $85.94 / $85.94
| Professional | | $47.89 | $85.94 | $85.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $278.20 / $568.94 / $980.74
| Facility | | $278.20 | $568.94 | $980.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.52 / $49.65 / $84.48
| Professional | | $35.52 | $49.65 | $84.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.42 / $61.88 / $580.00
| Facility | | $44.42 | $61.88 | $580.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.08 / $65.75 / $105.60
| Professional | | $43.08 | $65.75 | $105.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.59 / $67.72 / $101.96
| Facility | | $42.59 | $67.72 | $101.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $79.84 / $121.50 / $164.70
| Facility | 50 | $79.84 | $121.50 | $164.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.83 / $45.83 / $45.83
| Professional | | $45.83 | $45.83 | $45.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.90 / $74.90 / $117.88
| Professional | | $54.90 | $74.90 | $117.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.00 / $1,221.00 / $3,585.00
| Facility | | $225.00 | $1,221.00 | $3,585.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.34 / $59.65 / $117.45
| Professional | | $45.34 | $59.65 | $117.45 |