- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.56 / $89.56 / $89.56
| Facility | | $89.56 | $89.56 | $89.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.76 / $89.56 / $100.34
| Professional | | $42.76 | $89.56 | $100.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.10 / $1,878.00 / $4,256.00
| Facility | | $245.10 | $1,878.00 | $4,256.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.59 / $105.94 / $700.38
| Professional | | $73.59 | $105.94 | $700.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.99 / $58.14 / $74.16
| Facility | | $49.99 | $58.14 | $74.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.61 / $65.23 / $94.89
| Facility | | $37.61 | $65.23 | $94.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.43 / $45.76 / $118.16
| Professional | | $37.43 | $45.76 | $118.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.47 / $38.15 / $74.86
| Professional | | $25.47 | $38.15 | $74.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.59 / $99.08 / $142.26
| Professional | | $33.59 | $99.08 | $142.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.10 / $1,878.00 / $4,256.00
| Facility | | $245.10 | $1,878.00 | $4,256.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.59 / $103.66 / $700.38
| Professional | | $73.59 | $103.66 | $700.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.82 / $1,878.00 / $4,050.00
| Facility | | $52.82 | $1,878.00 | $4,050.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.56 / $93.68 / $162.85
| Professional | | $72.56 | $93.68 | $162.85 |