- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $2,089.30 / $3,715.35
| Facility | | $95.50 | $2,089.30 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $87.10 / $288.40
| Professional | | $25.12 | $87.10 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $208.93 / $407.38 / $489.78
| Professional | 50 | $208.93 | $407.38 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,862.09 / $19,498.45
| Facility | | $56.23 | $1,862.09 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $54.95 / $371.54
| Professional | | $26.30 | $54.95 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.54 / $27.54 / $63.10
| Facility | | $27.54 | $27.54 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $51.29 / $89.13
| Professional | | $36.31 | $51.29 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $60.26 / $398.11
| Professional | | $30.90 | $60.26 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.18 / $93.33 / $7,079.46
| Facility | | $28.18 | $93.33 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $50.12 / $70.79
| Professional | | $39.81 | $50.12 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,511.89 / $7,079.46
| Facility | | $1,096.48 | $2,511.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $47.86 / $97.72
| Professional | | $26.30 | $47.86 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,122.02 / $2,754.23
| Facility | | $912.01 | $1,122.02 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $61.66 / $112.20
| Professional | | $57.54 | $61.66 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,862.09 / $19,498.45
| Facility | | $56.23 | $1,862.09 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $54.95 / $371.54
| Professional | | $26.30 | $54.95 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,454.71 / $6,165.95
| Facility | | $1,047.13 | $2,454.71 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $61.66 / $309.03
| Professional | | $28.84 | $61.66 | $309.03 |