- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.02 / $229.09 / $1,380.38
| Facility | | $38.02 | $229.09 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $70.79 / $257.04
| Professional | | $36.31 | $70.79 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $79.43 / $158.49 / $407.38
| Professional | 50 | $79.43 | $158.49 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $758.58 / $1,698.24
| Facility | | $436.52 | $758.58 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $691.83 / $1,258.93 / $3,162.28
| Facility | 50 | $691.83 | $1,258.93 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $104.71 / $186.21
| Professional | | $66.07 | $104.71 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $95.50 / $154.88 / $257.04
| Professional | 50 | $95.50 | $154.88 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $204.17 / $489.78
| Facility | | $144.54 | $204.17 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $128.82 / $229.09
| Professional | | $75.86 | $128.82 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $194.98 / $380.19
| Facility | | $158.49 | $194.98 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $120.23 / $218.78
| Professional | | $79.43 | $120.23 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $97.72 / $691.83
| Facility | | $44.67 | $97.72 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $302.00 / $676.08 / $7,079.46
| Facility | 50 | $302.00 | $676.08 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $138.04 / $281.84
| Professional | | $58.88 | $138.04 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $162.18 / $263.03 / $436.52
| Professional | 50 | $162.18 | $263.03 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $1,819.70 / $3,467.37
| Facility | | $602.56 | $1,819.70 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $79.43 / $158.49
| Professional | | $43.65 | $79.43 | $158.49 |