- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.51 / $587.80 / $3,139.00
| Facility | | $79.51 | $587.80 | $3,139.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $369.64 / $553.26 / $1,190.00
| Facility | 50 | $369.64 | $553.26 | $1,190.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $28.67 / $37.74 / $50.70
| Facility | 52 | $28.67 | $37.74 | $50.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.23 / $72.03 / $105.91
| Professional | | $46.23 | $72.03 | $105.91 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $75.63 / $91.58 / $198.00
| Professional | 50 | $75.63 | $91.58 | $198.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.09 / $68.06 / $97.88
| Professional | | $48.09 | $68.06 | $97.88 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $72.14 / $105.00 / $120.12
| Professional | 50 | $72.14 | $105.00 | $120.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.76 / $423.70 / $649.24
| Facility | | $123.76 | $423.70 | $649.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.28 / $73.87 / $103.79
| Professional | | $56.28 | $73.87 | $103.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $255.95 / $255.95
| Facility | | $40.00 | $255.95 | $255.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $425.00 / $425.00
| Facility | | $425.00 | $425.00 | $425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.56 / $76.26 / $110.93
| Professional | | $48.56 | $76.26 | $110.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.00 / $543.00 / $1,560.00
| Facility | | $194.00 | $543.00 | $1,560.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.39 / $75.37 / $125.96
| Professional | | $53.39 | $75.37 | $125.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $80.00 / $85.00 / $156.00
| Professional | 50 | $80.00 | $85.00 | $156.00 |