- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.75 / $89.25 / $119.12
| Facility | | $69.75 | $89.25 | $119.12 |
- Facility/Professional
- Facility
- Modifier
- 25
- Low / Median / High Price
- $76.13 / $76.13 / $76.13
| Facility | 25 | $76.13 | $76.13 | $76.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.96 / $82.40 / $171.27
| Professional | | $61.96 | $82.40 | $171.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.19 / $192.82 / $650.00
| Facility | | $87.19 | $192.82 | $650.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $38.58 / $38.58 / $38.58
| Facility | AS | $38.58 | $38.58 | $38.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.90 / $104.78 / $459.05
| Professional | | $58.90 | $104.78 | $459.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.61 / $177.48 / $238.52
| Facility | | $92.61 | $177.48 | $238.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.64 / $147.74 / $196.01
| Professional | | $102.64 | $147.74 | $196.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.17 / $114.96 / $183.57
| Professional | | $70.17 | $114.96 | $183.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.66 / $84.66 / $5,733.00
| Facility | | $84.66 | $84.66 | $5,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.84 / $84.66 / $136.13
| Professional | | $47.84 | $84.66 | $136.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.67 / $172.36 / $233.17
| Professional | | $96.67 | $172.36 | $233.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.42 / $1,541.55 / $1,684.92
| Facility | | $116.42 | $1,541.55 | $1,684.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.11 / $130.00 / $198.35
| Professional | | $91.11 | $130.00 | $198.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.00 / $172.40 / $385.75
| Facility | | $165.00 | $172.40 | $385.75 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $38.58 / $38.58 / $38.58
| Facility | AS | $38.58 | $38.58 | $38.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.71 / $116.31 / $459.05
| Professional | | $63.71 | $116.31 | $459.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.12 / $79.50 / $144.84
| Professional | | $56.12 | $79.50 | $144.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.90 / $97.57 / $196.98
| Professional | | $58.90 | $97.57 | $196.98 |