- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.58 / $54.58 / $808.96
| Facility | | $54.58 | $54.58 | $808.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.58 / $66.18 / $830.70
| Professional | | $54.58 | $66.18 | $830.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.20 / $143.16 / $818.35
| Facility | | $78.20 | $143.16 | $818.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.99 / $95.01 / $384.82
| Professional | | $61.99 | $95.01 | $384.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.63 / $168.23 / $214.45
| Facility | | $144.63 | $168.23 | $214.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.98 / $110.30 / $290.38
| Professional | | $81.98 | $110.30 | $290.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.95 / $67.95 / $67.95
| Facility | | $67.95 | $67.95 | $67.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.56 / $78.69 / $172.84
| Professional | | $61.56 | $78.69 | $172.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.91 / $88.15 / $8,090.00
| Facility | | $56.91 | $88.15 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.20 / $61.25 / $103.26
| Professional | | $33.20 | $61.25 | $103.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.04 / $131.32 / $174.44
| Professional | | $70.04 | $131.32 | $174.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.97 / $174.34 / $1,208.68
| Facility | | $58.97 | $174.34 | $1,208.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.22 / $189.64 / $442.00
| Professional | | $92.22 | $189.64 | $442.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.68 / $133.68 / $274.45
| Facility | | $133.68 | $133.68 | $274.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.31 / $98.28 / $384.82
| Professional | | $65.31 | $98.28 | $384.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.99 / $84.31 / $162.68
| Professional | | $61.99 | $84.31 | $162.68 |