- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.18 / $1,473.20 / $3,363.00
| Facility | | $138.18 | $1,473.20 | $3,363.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $496.92 / $496.92 / $589.67
| Facility | 50 | $496.92 | $496.92 | $589.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.53 / $87.69 / $252.26
| Professional | | $47.53 | $87.69 | $252.26 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $206.95 / $430.50 / $1,386.62
| Professional | 50 | $206.95 | $430.50 | $1,386.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.94 / $1,177.70 / $3,472.00
| Facility | | $82.94 | $1,177.70 | $3,472.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.74 / $131.84 / $377.68
| Professional | | $56.74 | $131.84 | $377.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.35 / $76.26 / $139.02
| Facility | | $59.35 | $76.26 | $139.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.61 / $129.32 / $234.48
| Professional | | $75.61 | $129.32 | $234.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.45 / $120.65 / $220.65
| Professional | | $66.45 | $120.65 | $220.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.69 / $168.26 / $6,679.00
| Facility | | $60.69 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.42 / $125.28 / $172.92
| Professional | | $103.42 | $125.28 | $172.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.09 / $141.08 / $258.70
| Professional | | $67.09 | $141.08 | $258.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $647.58 / $784.42 / $843.87
| Facility | | $647.58 | $784.42 | $843.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.13 / $154.27 / $662.15
| Professional | | $138.13 | $154.27 | $662.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,600.00 / $7,161.00
| Facility | | $55.00 | $1,600.00 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.17 / $164.56 / $649.67
| Professional | | $94.17 | $164.56 | $649.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.23 / $92.27 / $191.65
| Professional | | $62.23 | $92.27 | $191.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.62 / $136.13 / $269.00
| Professional | | $88.62 | $136.13 | $269.00 |