- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.69 / $3,162.28 / $7,943.28
| Facility | | $41.69 | $3,162.28 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $38.90 / $218.78
| Professional | | $22.91 | $38.90 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $208.93 / $208.93 / $208.93
| Professional | 50 | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.50 / $19.50 / $25.70
| Professional | | $19.50 | $19.50 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $724.44 / $758.58
| Facility | | $218.78 | $724.44 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $114.82 / $309.03
| Professional | | $114.82 | $114.82 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $331.13
| Facility | | $331.13 | $331.13 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $72.44 / $251.19
| Professional | | $30.20 | $72.44 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.18 / $75.86 / $1,995.26
| Facility | | $28.18 | $75.86 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $173.78 / $1,949.84
| Professional | | $33.88 | $173.78 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $794.33 / $2,570.40
| Facility | | $524.81 | $794.33 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.54 / $44.67 / $288.40
| Professional | | $27.54 | $44.67 | $288.40 |