- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.79 / $55.02 / $2,168.00
| Facility | | $49.79 | $55.02 | $2,168.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.79 / $74.69 / $144.13
| Professional | | $49.79 | $74.69 | $144.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $108.51 / $108.51 / $108.51
| Professional | 50 | $108.51 | $108.51 | $108.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $378.60 / $938.85 / $2,042.46
| Facility | | $378.60 | $938.85 | $2,042.46 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $664.26 / $1,007.83 / $1,767.15
| Facility | 50 | $664.26 | $1,007.83 | $1,767.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.20 / $106.05 / $179.48
| Professional | | $75.20 | $106.05 | $179.48 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $109.61 / $155.09 / $255.77
| Professional | 50 | $109.61 | $155.09 | $255.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.12 / $180.36 / $433.88
| Facility | | $127.12 | $180.36 | $433.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.71 / $133.41 / $220.69
| Professional | | $85.71 | $133.41 | $220.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.39 / $164.89 / $341.64
| Facility | | $103.39 | $164.89 | $341.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.59 / $120.41 / $204.20
| Professional | | $77.59 | $120.41 | $204.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.38 / $91.82 / $720.78
| Facility | | $55.38 | $91.82 | $720.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.12 / $146.88 / $383.56
| Professional | | $75.12 | $146.88 | $383.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.00 / $1,749.00 / $2,883.00
| Facility | | $563.00 | $1,749.00 | $2,883.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.84 / $135.87 / $238.42
| Professional | | $71.84 | $135.87 | $238.42 |