- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.04 / $27.04 / $42.93
| Facility | | $27.04 | $27.04 | $42.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.18 / $33.79 / $45.43
| Professional | | $19.18 | $33.79 | $45.43 |
- 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
- $41.99 / $55.14 / $55.14
| Professional | | $41.99 | $55.14 | $55.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.59 / $66.59 / $66.59
| Facility | | $66.59 | $66.59 | $66.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.24 / $24.24 / $65.63
| Professional | | $24.24 | $24.24 | $65.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.73 / $55.14 / $104.77
| Professional | | $50.73 | $55.14 | $104.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.04 / $27.04 / $42.93
| Facility | | $27.04 | $27.04 | $42.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.00 / $33.79 / $52.15
| Professional | | $24.00 | $33.79 | $52.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.40 / $78.59 / $108.70
| Professional | | $68.40 | $78.59 | $108.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.59 / $66.59 / $66.59
| Facility | | $66.59 | $66.59 | $66.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.24 / $24.24 / $65.63
| Professional | | $24.24 | $24.24 | $65.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.43 / $52.49 / $52.49
| Facility | | $39.43 | $52.49 | $52.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.43 / $52.49 / $53.78
| Professional | | $39.43 | $52.49 | $53.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.41 / $27.52 / $48.19
| Professional | | $19.41 | $27.52 | $48.19 |