- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.02 / $38.02 / $38.02
| Facility | | $38.02 | $38.02 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $53.70 / $177.83
| Professional | | $31.62 | $53.70 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $87.10 / $426.58
| Facility | | $85.11 | $87.10 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $69.18 / $128.82
| Professional | | $39.81 | $69.18 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $114.82 / $154.88
| Facility | | $100.00 | $114.82 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $57.54 / $57.54
| Professional | | $57.54 | $57.54 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $58.88 / $138.04
| Facility | | $58.88 | $58.88 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $43.65 / $69.18
| Professional | | $43.65 | $43.65 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $77.62 / $117.49
| Professional | | $77.62 | $77.62 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $58.88 / $70.79
| Facility | | $58.88 | $58.88 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $58.88 / $70.79
| Professional | | $58.88 | $58.88 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $87.10 / $426.58
| Facility | | $85.11 | $87.10 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.81 / $72.44 / $138.04
| Professional | | $39.81 | $72.44 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $79.43
| Professional | | $60.26 | $60.26 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.62 / $52.48 / $63.10
| Facility | | $31.62 | $52.48 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $61.66 / $83.18
| Professional | | $36.31 | $61.66 | $83.18 |