- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.25 / $183.00 / $1,375.81
| Facility | | $36.25 | $183.00 | $1,375.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.17 / $57.07 / $195.71
| Professional | | $35.17 | $57.07 | $195.71 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $77.51 / $193.54 / $325.98
| Professional | 50 | $77.51 | $193.54 | $325.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $383.28 / $733.63 / $1,197.76
| Facility | | $383.28 | $733.63 | $1,197.76 |
- 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
- $68.02 / $121.41 / $194.73
| Professional | | $68.02 | $121.41 | $194.73 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $101.72 / $175.58 / $283.33
| Professional | 50 | $101.72 | $175.58 | $283.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.38 / $193.50 / $465.49
| Facility | | $136.38 | $193.50 | $465.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.15 / $126.69 / $231.64
| Professional | | $77.15 | $126.69 | $231.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.75 / $176.90 / $366.53
| Facility | | $119.75 | $176.90 | $366.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.95 / $118.65 / $211.22
| Professional | | $74.95 | $118.65 | $211.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.48 / $84.42 / $469.50
| Facility | | $44.48 | $84.42 | $469.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $304.67 / $680.03 / $7,044.75
| Facility | 50 | $304.67 | $680.03 | $7,044.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.75 / $130.94 / $279.00
| Professional | | $64.75 | $130.94 | $279.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $161.97 / $265.83 / $432.63
| Professional | 50 | $161.97 | $265.83 | $432.63 |
- 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
- $56.48 / $94.64 / $196.26
| Professional | | $56.48 | $94.64 | $196.26 |