- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $2,818.38 / $5,623.41
| Facility | | $109.65 | $2,818.38 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $120.23 / $229.09
| Professional | | $85.11 | $120.23 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $147.91 / $288.40 / $660.69
| Professional | 50 | $147.91 | $288.40 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $630.96 / $2,754.23
| Facility | | $56.23 | $630.96 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $131.83 / $309.03
| Professional | | $74.13 | $131.83 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $95.50 / $218.78
| Facility | | $95.50 | $95.50 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $162.18 / $234.42
| Professional | | $95.50 | $162.18 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $169.82 / $295.12
| Professional | | $91.20 | $169.82 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $177.83 / $7,079.46
| Facility | | $75.86 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $131.83 / $186.21
| Professional | | $102.33 | $131.83 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,862.09 / $3,467.37
| Facility | | $501.19 | $1,862.09 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $138.04 / $251.19
| Professional | | $87.10 | $138.04 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $3,890.45 / $3,890.45
| Facility | | $3,890.45 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $158.49 / $169.82
| Professional | | $74.13 | $158.49 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $676.08 / $2,818.38
| Facility | | $56.23 | $676.08 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $131.83 / $309.03
| Professional | | $74.13 | $131.83 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $138.04 / $257.04
| Professional | | $87.10 | $138.04 | $257.04 |