- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.30 / $199.75 / $402.40
| Facility | | $28.30 | $199.75 | $402.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.21 / $35.36 / $45.04
| Professional | | $25.21 | $35.36 | $45.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $967.00 / $57,255.43 / $79,506.39
| Facility | | $967.00 | $57,255.43 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.71 / $57.71 / $57.71
| Professional | | $57.71 | $57.71 | $57.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.66 / $69.66 / $69.66
| Facility | | $69.66 | $69.66 | $69.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.73 / $31.73 / $31.73
| Professional | | $31.73 | $31.73 | $31.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.60 / $78.14 / $83.68
| Professional | | $60.60 | $78.14 | $83.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.31 / $70.33 / $111.75
| Facility | | $62.31 | $70.33 | $111.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.30 / $201.20 / $402.40
| Facility | | $28.30 | $201.20 | $402.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.01 / $35.36 / $48.71
| Professional | | $28.01 | $35.36 | $48.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.50 / $113.70 / $113.70
| Professional | | $93.50 | $113.70 | $113.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.66 / $69.66 / $69.66
| Facility | | $69.66 | $69.66 | $69.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.73 / $31.73 / $31.73
| Professional | | $31.73 | $31.73 | $31.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.41 / $54.93 / $54.93
| Facility | | $50.41 | $54.93 | $54.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.41 / $54.93 / $56.30
| Professional | | $50.41 | $54.93 | $56.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.18 / $29.65 / $55.00
| Professional | | $25.18 | $29.65 | $55.00 |