- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $1,000.00 / $1,995.26
| Facility | | $79.43 | $1,000.00 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $52.48 / $117.49
| Professional | | $33.11 | $52.48 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $46.77 / $147.91 / $177.83
| Professional | 50 | $46.77 | $147.91 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $53.70 / $87.10
| Professional | | $29.51 | $53.70 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $36.31 / $74.13 / $151.36
| Professional | 50 | $36.31 | $74.13 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $32.36
| Facility | | $32.36 | $32.36 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $109.65 / $109.65
| Professional | | $30.90 | $109.65 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $32.36 / $363.08
| Facility | | $29.51 | $32.36 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $64.57 / $102.33
| Professional | | $42.66 | $64.57 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $562.34 / $1,621.81
| Facility | | $223.87 | $562.34 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $51.29 / $112.20
| Professional | | $33.11 | $51.29 | $112.20 |