- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.41 / $722.32 / $844.38
| Facility | | $76.41 | $722.32 | $844.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $756.71 / $756.71 / $756.71
| Facility | 50 | $756.71 | $756.71 | $756.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.34 / $97.00 / $154.13
| Professional | | $57.34 | $97.00 | $154.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.46 / $75.51 / $124.51
| Professional | | $61.46 | $75.51 | $124.51 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $92.19 / $105.51 / $186.76
| Professional | 50 | $92.19 | $105.51 | $186.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.87 / $115.25 / $198.33
| Professional | | $66.87 | $115.25 | $198.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $491.38 / $491.38 / $491.38
| Facility | | $491.38 | $491.38 | $491.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.31 / $143.44 / $230.29
| Professional | | $78.31 | $143.44 | $230.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.41 / $677.78 / $12,088.55
| Facility | | $76.41 | $677.78 | $12,088.55 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $756.71 / $756.71 / $756.71
| Facility | 50 | $756.71 | $756.71 | $756.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.79 / $104.75 / $161.76
| Professional | | $62.79 | $104.75 | $161.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.76 / $159.40 / $226.75
| Professional | | $76.76 | $159.40 | $226.75 |