- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.40 / $428.84 / $1,559.50
| Facility | | $32.40 | $428.84 | $1,559.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,690.06 / $1,690.06 / $1,690.06
| Facility | 50 | $1,690.06 | $1,690.06 | $1,690.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.52 / $51.23 / $142.56
| Professional | | $31.52 | $51.23 | $142.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.88 / $648.79 / $1,465.73
| Facility | | $153.88 | $648.79 | $1,465.73 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $940.45 / $1,426.87 / $2,501.90
| Facility | 50 | $940.45 | $1,426.87 | $2,501.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.28 / $129.31 / $281.07
| Professional | | $66.28 | $129.31 | $281.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $187.50 / $292.64 / $703.98
| Facility | | $187.50 | $292.64 | $703.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.06 / $120.76 / $323.32
| Professional | | $49.06 | $120.76 | $323.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.47 / $258.01 / $554.30
| Facility | | $162.47 | $258.01 | $554.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.20 / $130.90 / $281.95
| Professional | | $66.20 | $130.90 | $281.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.53 / $90.51 / $544.33
| Facility | | $42.53 | $90.51 | $544.33 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $160.97 / $1,579.50 / $1,654.47
| Facility | 50 | $160.97 | $1,579.50 | $1,654.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.36 / $113.76 / $1,650.00
| Professional | | $47.36 | $113.76 | $1,650.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.00 / $1,749.00 / $2,883.00
| Facility | | $563.00 | $1,749.00 | $2,883.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.92 / $98.57 / $285.52
| Professional | | $51.92 | $98.57 | $285.52 |