- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $2,691.53 / $5,623.41
| Facility | | $125.89 | $2,691.53 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $104.71 / $295.12
| Professional | | $56.23 | $104.71 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $199.53 / $346.74 / $1,071.52
| Professional | 50 | $199.53 | $346.74 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,174.90 / $3,548.13
| Facility | | $56.23 | $1,174.90 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $123.03 / $371.54
| Professional | | $63.10 | $123.03 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $72.44 / $169.82
| Facility | | $72.44 | $72.44 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $165.96 / $363.08
| Professional | | $85.11 | $165.96 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $134.90 / $281.84
| Professional | | $69.18 | $134.90 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $128.82 / $7,079.46
| Facility | | $63.10 | $128.82 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $190.55 / $263.03
| Professional | | $154.88 | $190.55 | $263.03 |
- 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
- $74.13 / $162.18 / $346.74
| Professional | | $74.13 | $162.18 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.86 / $616.60 / $912.01
| Facility | | $47.86 | $616.60 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $74.13 / $218.78
| Professional | | $61.66 | $74.13 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,174.90 / $3,548.13
| Facility | | $56.23 | $1,174.90 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $123.03 / $371.54
| Professional | | $63.10 | $123.03 | $371.54 |
- 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
- $66.07 / $123.03 / $323.59
| Professional | | $66.07 | $123.03 | $323.59 |