- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.11 / $315.08 / $498.84
| Facility | | $53.11 | $315.08 | $498.84 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $237.86 / $403.37 / $498.08
| Facility | 50 | $237.86 | $403.37 | $498.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.22 / $60.91 / $110.52
| Professional | | $26.22 | $60.91 | $110.52 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $43.08 / $137.72 / $137.72
| Professional | 50 | $43.08 | $137.72 | $137.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,974.00 / $2,971.00 / $7,022.00
| Facility | | $1,974.00 | $2,971.00 | $7,022.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.36 / $37.68 / $60.45
| Professional | | $29.36 | $37.68 | $60.45 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $20.73 / $35.52 / $107.72
| Professional | 50 | $20.73 | $35.52 | $107.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.66 / $92.66 / $291.87
| Facility | | $92.66 | $92.66 | $291.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.92 / $84.66 / $142.52
| Professional | | $31.92 | $84.66 | $142.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.22 / $75.51 / $138.13
| Facility | | $26.22 | $75.51 | $138.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.75 / $87.95 / $151.07
| Professional | | $33.75 | $87.95 | $151.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $730.00 / $1,491.00 / $2,720.00
| Facility | | $730.00 | $1,491.00 | $2,720.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.78 / $121.92 / $201.15
| Professional | | $81.78 | $121.92 | $201.15 |