- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $645.65 / $1,584.89
| Facility | | $36.31 | $645.65 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $426.58 / $1,174.90 / $1,949.84
| Facility | 50 | $426.58 | $1,174.90 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $72.44 / $123.03
| Professional | | $36.31 | $72.44 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $79.43 / $154.88 / $213.80
| Professional | 50 | $79.43 | $154.88 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.62 / $31.62 / $31.62
| Facility | | $31.62 | $31.62 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $56.23 / $97.72
| Professional | | $38.02 | $56.23 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $794.33 / $5,011.87
| Facility | | $602.56 | $794.33 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,479.11 / $1,479.11 / $1,513.56
| Facility | 50 | $1,479.11 | $1,479.11 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $54.95 / $75.86
| Professional | | $36.31 | $54.95 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $54.95 / $56.23 / $114.82
| Professional | 50 | $54.95 | $56.23 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $144.54 / $501.19
| Facility | | $144.54 | $144.54 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.67 / $52.48 / $85.11
| Professional | | $34.67 | $52.48 | $85.11 |