- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $467.74 / $7,943.28
| Facility | | $45.71 | $467.74 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $346.74 / $346.74 / $346.74
| Facility | 50 | $346.74 | $346.74 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.48 / $61.66 / $125.89
| Professional | | $35.48 | $61.66 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $46.77 / $72.44
| Professional | | $33.88 | $46.77 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $549.54 / $1,000.00
| Facility | | $234.42 | $549.54 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $50.12 / $69.18
| Professional | | $36.31 | $50.12 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $61.66 / $575.44
| Facility | | $44.67 | $61.66 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $64.57 / $97.72
| Professional | | $43.65 | $64.57 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $87.10 / $123.03
| Professional | | $87.10 | $87.10 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $61.66 / $102.33
| Facility | | $39.81 | $61.66 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $1,230.27 / $3,548.13
| Facility | | $354.81 | $1,230.27 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $50.12 / $85.11
| Professional | | $33.11 | $50.12 | $85.11 |