- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.81 / $202.74 / $3,363.00
| Facility | | $49.81 | $202.74 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.81 / $130.97 / $354.22
| Professional | | $49.81 | $130.97 | $354.22 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $153.38 / $309.06 / $734.90
| Professional | 50 | $153.38 | $309.06 | $734.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.22 / $272.35 / $2,733.00
| Facility | | $105.22 | $272.35 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.50 / $144.29 / $666.95
| Professional | | $54.50 | $144.29 | $666.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.63 / $72.31 / $127.62
| Facility | | $55.63 | $72.31 | $127.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $95.36 / $211.59
| Professional | | $15.14 | $95.36 | $211.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.87 / $146.77 / $254.95
| Professional | | $75.87 | $146.77 | $254.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.29 / $168.26 / $6,679.00
| Facility | | $56.29 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.87 / $117.35 / $209.81
| Professional | | $92.87 | $117.35 | $209.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.45 / $130.22 / $219.55
| Professional | | $60.45 | $130.22 | $219.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.67 / $127.63 / $222.03
| Facility | | $74.67 | $127.63 | $222.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.50 / $126.81 / $167.47
| Professional | | $69.50 | $126.81 | $167.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,078.00 / $3,445.00
| Facility | | $55.00 | $1,078.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.53 / $219.22 / $666.95
| Professional | | $105.53 | $219.22 | $666.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.17 / $145.41 / $286.14
| Professional | | $94.17 | $145.41 | $286.14 |