- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $3,388.44 / $4,570.88
| Facility | | $107.15 | $3,388.44 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $457.09 / $457.09 / $457.09
| Facility | 50 | $457.09 | $457.09 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $109.65 / $204.17
| Professional | | $79.43 | $109.65 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $147.91 / $147.91 / $147.91
| Professional | 50 | $147.91 | $147.91 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $128.82 / $173.78
| Professional | | $77.62 | $128.82 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $144.54
| Professional | | $32.36 | $33.11 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $524.81 / $1,584.89
| Facility | | $446.68 | $524.81 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $158.49 / $251.19
| Professional | | $109.65 | $158.49 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $131.83 / $218.78
| Professional | | $89.13 | $131.83 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $120.23 / $165.96
| Professional | | $97.72 | $120.23 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $4,466.84 / $5,128.61
| Facility | | $1,071.52 | $4,466.84 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $102.33 / $154.88
| Professional | | $75.86 | $102.33 | $154.88 |