- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.50 / $47.50 / $185.15
| Facility | | $47.50 | $47.50 | $185.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.11 / $47.50 / $60.03
| Professional | | $41.11 | $47.50 | $60.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.88 / $51.77 / $84.43
| Professional | | $49.88 | $51.77 | $84.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.00 / $68.91 / $110.86
| Professional | | $54.00 | $68.91 | $110.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.85 / $81.98 / $81.98
| Professional | | $60.85 | $81.98 | $81.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.66 / $116.66 / $116.66
| Facility | | $116.66 | $116.66 | $116.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.50 / $180.69 / $342.00
| Facility | | $47.50 | $180.69 | $342.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.11 / $49.80 / $128.25
| Professional | | $41.11 | $49.80 | $128.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.30 / $89.80 / $123.10
| Professional | | $66.30 | $89.80 | $123.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.64 / $68.91 / $115.50
| Professional | | $53.64 | $68.91 | $115.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.21 / $49.21 / $73.98
| Facility | | $49.21 | $49.21 | $73.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.82 / $50.34 / $73.98
| Professional | | $46.82 | $50.34 | $73.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $557.00 / $3,742.00
| Facility | | $162.00 | $557.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.24 / $64.05 / $102.54
| Professional | | $49.24 | $64.05 | $102.54 |