- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.79 / $21.83 / $21.83
| Facility | | $20.79 | $21.83 | $21.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.12 / $20.79 / $28.29
| Professional | | $12.12 | $20.79 | $28.29 |
- 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
- $39.57 / $62.83 / $65.20
| Professional | | $39.57 | $62.83 | $65.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.17 / $25.17 / $68.48
| Facility | | $25.17 | $25.17 | $68.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.39 / $21.39 / $29.37
| Professional | | $21.39 | $21.39 | $29.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.10 / $83.10 / $83.10
| Facility | | $83.10 | $83.10 | $83.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.40 / $48.28 / $62.22
| Professional | | $36.40 | $48.28 | $62.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.72 / $26.72 / $26.72
| Professional | | $26.72 | $26.72 | $26.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.83 / $21.83 / $21.83
| Facility | | $21.83 | $21.83 | $21.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.11 / $21.84 / $30.84
| Professional | | $11.11 | $21.84 | $30.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.40 / $59.50 / $78.00
| Professional | | $49.40 | $59.50 | $78.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.17 / $25.17 / $68.48
| Facility | | $25.17 | $25.17 | $68.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.39 / $21.39 / $45.75
| Professional | | $21.39 | $21.39 | $45.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.30 / $37.65 / $37.65
| Facility | | $28.30 | $37.65 | $37.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.30 / $37.65 / $37.65
| Professional | | $28.30 | $37.65 | $37.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.99 / $19.73 / $35.70
| Professional | | $13.99 | $19.73 | $35.70 |