- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $1,819.70 / $3,715.35
| Facility | | $138.04 | $1,819.70 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $123.03 / $354.81
| Professional | | $56.23 | $123.03 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $173.78 / $501.19 / $758.58
| Professional | 50 | $173.78 | $501.19 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,174.90 / $3,801.89
| Facility | | $56.23 | $1,174.90 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $131.83 / $354.81
| Professional | | $58.88 | $131.83 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $63.10 / $147.91
| Facility | | $63.10 | $63.10 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $165.96 / $245.47
| Professional | | $81.28 | $165.96 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $151.36 / $281.84
| Professional | | $69.18 | $151.36 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $107.15 / $7,079.46
| Facility | | $56.23 | $107.15 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $173.78 / $245.47
| Professional | | $141.25 | $173.78 | $245.47 |
- 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
- $60.26 / $138.04 / $316.23
| Professional | | $60.26 | $138.04 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $537.03 / $4,365.16
| Facility | | $144.54 | $537.03 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,174.90 / $3,801.89
| Facility | | $56.23 | $1,174.90 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $131.83 / $354.81
| Professional | | $58.88 | $131.83 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,344.23 / $6,165.95
| Facility | | $954.99 | $2,344.23 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $141.25 / $309.03
| Professional | | $67.61 | $141.25 | $309.03 |