- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $575.44 / $10,232.93
| Facility | | $51.29 | $575.44 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $72.44 / $162.18
| Professional | | $51.29 | $72.44 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $208.93 / $208.93 / $208.93
| Professional | 50 | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $63.10 / $64.57
| Professional | | $60.26 | $63.10 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $3,467.37 / $4,466.84
| Facility | | $1,513.56 | $3,467.37 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $54.95 / $97.72
| Professional | | $47.86 | $54.95 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.70 / $81.28 / $199.53
| Professional | | $53.70 | $81.28 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.15 / $72.44 / $117.49
| Professional | | $37.15 | $72.44 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.72 / $61.66 / $100.00
| Professional | | $0.72 | $61.66 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $66.07 / $66.07
| Professional | | $41.69 | $66.07 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $1,288.25 / $2,041.74
| Facility | | $199.53 | $1,288.25 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $67.61 / $107.15
| Professional | | $51.29 | $67.61 | $107.15 |