- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $1,071.52 / $9,120.11
| Facility | | $60.26 | $1,071.52 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $691.83 / $691.83 / $691.83
| Facility | 50 | $691.83 | $691.83 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $91.20 / $245.47
| Professional | | $50.12 | $91.20 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $114.82 / $281.84 / $524.81
| Professional | 50 | $114.82 | $281.84 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $85.11 / $147.91
| Professional | | $72.44 | $85.11 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $239.88 / $239.88 / $239.88
| Professional | 50 | $239.88 | $239.88 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,096.48 / $1,819.70
| Facility | | $575.44 | $1,096.48 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $102.33 / $234.42
| Professional | | $46.77 | $102.33 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $89.13 / $100.00
| Facility | | $89.13 | $89.13 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $100.00 / $158.49
| Professional | | $64.57 | $100.00 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $204.17 / $204.17
| Professional | | $204.17 | $204.17 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $89.13 / $147.91
| Facility | | $52.48 | $89.13 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $3,890.45 / $7,762.47
| Facility | | $1,096.48 | $3,890.45 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $75.86 / $131.83
| Professional | | $46.77 | $75.86 | $131.83 |