- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.61 / $49.71 / $131.00
| Facility | | $32.61 | $49.71 | $131.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.94 / $48.75 / $182.45
| Professional | | $31.94 | $48.75 | $182.45 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $64.14 / $64.14 / $64.88
| Professional | 50 | $64.14 | $64.14 | $64.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.42 / $504.98 / $1,052.56
| Facility | | $68.42 | $504.98 | $1,052.56 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $675.36 / $1,024.66 / $1,796.66
| Facility | 50 | $675.36 | $1,024.66 | $1,796.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.02 / $110.33 / $175.97
| Professional | | $63.02 | $110.33 | $175.97 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $91.59 / $158.55 / $256.04
| Professional | 50 | $91.59 | $158.55 | $256.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.59 / $176.78 / $425.26
| Facility | | $124.59 | $176.78 | $425.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.54 / $116.46 / $212.93
| Professional | | $70.54 | $116.46 | $212.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.49 / $161.62 / $334.85
| Facility | | $109.49 | $161.62 | $334.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.91 / $108.48 / $194.16
| Professional | | $68.91 | $108.48 | $194.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.01 / $74.50 / $149.11
| Facility | | $45.01 | $74.50 | $149.11 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,026.01 / $1,026.01 / $1,026.01
| Facility | 50 | $1,026.01 | $1,026.01 | $1,026.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.78 / $105.09 / $251.68
| Professional | | $54.78 | $105.09 | $251.68 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $94.50 / $248.42 / $305.36
| Professional | 50 | $94.50 | $248.42 | $305.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.00 / $1,727.00 / $2,883.00
| Facility | | $382.00 | $1,727.00 | $2,883.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $95.42 / $192.23
| Professional | | $52.48 | $95.42 | $192.23 |