- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $338.84 / $602.56
| Facility | | $77.62 | $338.84 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $194.98 / $562.34
| Professional | | $75.86 | $194.98 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $112.20 / $1,258.93 / $1,258.93
| Professional | 50 | $112.20 | $1,258.93 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $309.03 / $691.83
| Facility | | $181.97 | $309.03 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $302.00 / $549.54 / $1,380.38
| Facility | 50 | $302.00 | $549.54 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $323.59 / $776.25
| Professional | | $131.83 | $323.59 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $199.53 / $457.09 / $1,122.02
| Professional | 50 | $199.53 | $457.09 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $912.01 / $2,187.76
| Facility | | $630.96 | $912.01 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $426.58 / $1,023.29
| Professional | | $173.78 | $426.58 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $870.96 / $1,737.80
| Facility | | $707.95 | $870.96 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $416.87 / $977.24
| Professional | | $162.18 | $416.87 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $275.42 / $1,445.44
| Facility | | $109.65 | $275.42 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $281.84 / $398.11 / $5,128.61
| Facility | 50 | $281.84 | $398.11 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $489.78 / $1,230.27
| Professional | | $239.88 | $489.78 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,862.09 / $3,715.35
| Facility | | $467.74 | $1,862.09 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $295.12 / $794.33
| Professional | | $112.20 | $295.12 | $794.33 |