- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.86 / $354.81 / $5,623.41
| Facility | | $47.86 | $354.81 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $70.79 / $354.81 / $3,311.31
| Facility | 50 | $70.79 | $354.81 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $30.90 / $85.11 / $776.25
| Facility | 52 | $30.90 | $85.11 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $57.54 / $144.54
| Professional | | $30.90 | $57.54 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- 22
- Low / Median / High Price
- $42.66 / $134.90 / $239.88
| Professional | 22 | $42.66 | $134.90 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $56.23 / $112.20 / $295.12
| Professional | 50 | $56.23 | $112.20 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $30.20 / $43.65 / $95.50
| Professional | 52 | $30.20 | $43.65 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $3,715.35 / $9,332.54
| Facility | | $1,548.82 | $3,715.35 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $51.29 / $97.72
| Professional | | $26.92 | $51.29 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $35.48 / $75.86 / $141.25
| Professional | 50 | $35.48 | $75.86 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $147.91 / $416.87
| Facility | | $50.12 | $147.91 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $43.65 / $43.65 / $43.65
| Facility | 52 | $43.65 | $43.65 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $61.66 / $141.25
| Professional | | $36.31 | $61.66 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $1,071.52 / $3,467.37
| Facility | | $158.49 | $1,071.52 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $50.12 / $93.33
| Professional | | $30.90 | $50.12 | $93.33 |