- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.70 / $776.25 / $4,265.80
| Facility | | $53.70 | $776.25 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $0.58 / $977.24 / $3,890.45
| Facility | 50 | $0.58 | $977.24 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $64.57 / $173.78
| Professional | | $30.20 | $64.57 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.99 / $33.11 / $67.61
| Professional | | $23.99 | $33.11 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $77.62 / $131.83
| Professional | | $51.29 | $77.62 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $54.95 / $54.95
| Facility | | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $67.61 / $177.83
| Professional | | $38.90 | $67.61 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $64.57 / $64.57
| Professional | | $64.57 | $64.57 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $66.07 / $144.54
| Facility | | $32.36 | $66.07 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $30.90 / $30.90
| Professional | | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $79.43 / $218.78
| Professional | | $33.11 | $79.43 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $724.44 / $1,949.84
| Facility | | $114.82 | $724.44 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $63.10 / $131.83
| Professional | | $33.11 | $63.10 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,951.21 / $2,951.21
| Facility | | $56.23 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,659.59 / $1,659.59 / $1,659.59
| Professional | | $1,659.59 | $1,659.59 | $1,659.59 |