- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.36 / $84.49 / $1,072.46
| Facility | | $45.36 | $84.49 | $1,072.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.71 / $69.47 / $139.44
| Professional | | $42.71 | $69.47 | $139.44 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $99.29 / $99.29 / $173.54
| Professional | 50 | $99.29 | $99.29 | $173.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.68 / $504.98 / $1,052.56
| Facility | | $91.68 | $504.98 | $1,052.56 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $675.36 / $1,024.66 / $1,796.66
| Facility | 50 | $675.36 | $1,024.66 | $1,796.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.81 / $154.75 / $283.33
| Professional | | $86.81 | $154.75 | $283.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $128.94 / $232.13 / $425.01
| Professional | 50 | $128.94 | $232.13 | $425.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.19 / $293.83 / $706.85
| Facility | | $191.19 | $293.83 | $706.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.99 / $180.75 / $337.76
| Professional | | $96.99 | $180.75 | $337.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $168.44 / $268.63 / $556.58
| Facility | | $168.44 | $268.63 | $556.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.03 / $166.77 / $308.89
| Professional | | $96.03 | $166.77 | $308.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.70 / $123.40 / $531.48
| Facility | | $61.70 | $123.40 | $531.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.14 / $171.05 / $340.80
| Professional | | $86.14 | $171.05 | $340.80 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $253.07 / $405.19 / $780.30
| Professional | 50 | $253.07 | $405.19 | $780.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.00 / $1,727.00 / $2,883.00
| Facility | | $382.00 | $1,727.00 | $2,883.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.87 / $141.11 / $288.10
| Professional | | $80.87 | $141.11 | $288.10 |