- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.24 / $667.00 / $2,747.00
| Facility | | $89.24 | $667.00 | $2,747.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $46.46 / $97.00 / $549.22
| Facility | 50 | $46.46 | $97.00 | $549.22 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $13.64 / $21.20 / $23.23
| Facility | 52 | $13.64 | $21.20 | $23.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.78 / $76.23 / $189.80
| Professional | | $37.78 | $76.23 | $189.80 |
- Facility/Professional
- Professional
- Modifier
- 22
- Low / Median / High Price
- $238.03 / $238.03 / $238.03
| Professional | 22 | $238.03 | $238.03 | $238.03 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $75.00 / $170.88 / $293.26
| Professional | 50 | $75.00 | $170.88 | $293.26 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $13.64 / $21.20 / $56.34
| Professional | 52 | $13.64 | $21.20 | $56.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.73 / $182.35 / $2,733.00
| Facility | | $71.73 | $182.35 | $2,733.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $125.18 / $125.18 / $125.18
| Facility | 52 | $125.18 | $125.18 | $125.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.76 / $82.40 / $348.00
| Professional | | $35.76 | $82.40 | $348.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.65 / $47.66 / $84.10
| Facility | | $36.65 | $47.66 | $84.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.70 / $80.58 / $124.12
| Professional | | $46.70 | $80.58 | $124.12 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $57.05 / $57.05 / $57.05
| Professional | 50 | $57.05 | $57.05 | $57.05 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $33.97 / $46.79 / $63.38
| Professional | 52 | $33.97 | $46.79 | $63.38 |
- 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
- $50.00 / $92.15 / $149.22
| Professional | | $50.00 | $92.15 | $149.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.46 / $83.43 / $8,090.00
| Facility | | $37.46 | $83.43 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.02 / $69.53 / $124.31
| Professional | | $55.02 | $69.53 | $124.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.29 / $86.81 / $130.63
| Professional | | $40.29 | $86.81 | $130.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.13 / $151.55 / $571.54
| Facility | | $148.13 | $151.55 | $571.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.39 / $85.57 / $145.69
| Professional | | $43.39 | $85.57 | $145.69 |
- 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
- Facility
- Modifier
- 52
- Low / Median / High Price
- $125.18 / $125.18 / $125.18
| Facility | 52 | $125.18 | $125.18 | $125.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.02 / $125.01 / $348.00
| Professional | | $55.02 | $125.01 | $348.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.87 / $75.48 / $114.98
| Facility | | $23.87 | $75.48 | $114.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.08 / $48.13 / $92.86
| Professional | | $38.08 | $48.13 | $92.86 |
- 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
- $50.95 / $84.70 / $168.44
| Professional | | $50.95 | $84.70 | $168.44 |