- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $2,754.23 / $4,897.79
| Facility | | $194.98 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $218.78 / $870.96
| Professional | | $125.89 | $218.78 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $660.69 / $691.83 / $1,584.89
| Professional | 50 | $660.69 | $691.83 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,023.29 / $3,019.95
| Facility | | $56.23 | $1,023.29 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $263.03 / $660.69
| Professional | | $141.25 | $263.03 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $165.96 / $380.19
| Facility | | $165.96 | $165.96 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $281.84 / $446.68
| Professional | | $281.84 | $281.84 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $338.84 / $645.65
| Professional | | $186.21 | $338.84 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $218.78 / $7,079.46
| Facility | | $128.82 | $218.78 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $323.59 / $512.86
| Professional | | $257.04 | $323.59 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $263.03 / $562.34
| Professional | | $151.36 | $263.03 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,023.29 / $3,019.95
| Facility | | $56.23 | $1,023.29 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $263.03 / $645.65
| Professional | | $141.25 | $263.03 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,862.09 / $2,818.38
| Facility | | $630.96 | $1,862.09 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $281.84 / $575.44
| Professional | | $154.88 | $281.84 | $575.44 |