- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $602.56 / $3,890.45
| Facility | | $64.57 | $602.56 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $512.86 / $512.86 / $512.86
| Facility | 50 | $512.86 | $512.86 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $85.11 / $162.18
| Professional | | $47.86 | $85.11 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $251.19 / $251.19 / $263.03
| Professional | 50 | $251.19 | $251.19 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $79.43 / $104.71
| Professional | | $38.02 | $79.43 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $165.96 / $263.03
| Facility | | $107.15 | $165.96 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $72.44 / $104.71
| Professional | | $46.77 | $72.44 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $45.71 / $45.71
| Facility | | $39.81 | $45.71 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $85.11 / $147.91
| Professional | | $51.29 | $85.11 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $426.58 / $1,202.26
| Facility | | $177.83 | $426.58 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $81.28 / $144.54
| Professional | | $45.71 | $81.28 | $144.54 |