- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.58 / $56.01 / $350.53
| Facility | | $10.58 | $56.01 | $350.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.58 / $20.00 / $577.01
| Professional | | $10.58 | $20.00 | $577.01 |
- 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
- $343.26 / $356.22 / $601.85
| Professional | | $343.26 | $356.22 | $601.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.78 / $160.59 / $419.76
| Facility | | $105.78 | $160.59 | $419.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.44 / $204.44 / $255.54
| Professional | | $204.44 | $204.44 | $255.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.94 / $259.00 / $768.10
| Facility | | $181.94 | $259.00 | $768.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.64 / $35.34 / $393.78
| Facility | | $11.64 | $35.34 | $393.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.58 / $20.00 / $577.01
| Professional | | $10.58 | $20.00 | $577.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.78 / $210.43 / $431.80
| Facility | | $105.78 | $210.43 | $431.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.44 / $204.44 / $255.54
| Professional | | $204.44 | $204.44 | $255.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.20 / $61.20 / $61.20
| Facility | | $61.20 | $61.20 | $61.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.20 / $61.20 / $61.20
| Professional | | $61.20 | $61.20 | $61.20 |