- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.53 / $102.57 / $147.08
| Facility | | $47.53 | $102.57 | $147.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.53 / $49.45 / $6,061.83
| Professional | | $47.53 | $49.45 | $6,061.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.83 / $51.56 / $8,639.91
| Facility | | $43.83 | $51.56 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.32 / $49.32 / $51.57
| Professional | | $49.32 | $49.32 | $51.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.83 / $47.52 / $47.52
| Facility | | $44.83 | $47.52 | $47.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.52 / $47.52 / $47.52
| Professional | | $47.52 | $47.52 | $47.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.86 / $82.57 / $147.08
| Facility | | $48.86 | $82.57 | $147.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.53 / $54.65 / $6,061.83
| Professional | | $47.53 | $54.65 | $6,061.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.83 / $47.52 / $47.52
| Facility | | $44.83 | $47.52 | $47.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.52 / $47.52 / $47.52
| Professional | | $47.52 | $47.52 | $47.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.07 / $41.07 / $47.65
| Facility | | $41.07 | $41.07 | $47.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.07 / $41.07 / $47.65
| Professional | | $41.07 | $41.07 | $47.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.53 / $53.23 / $86.98
| Professional | | $47.53 | $53.23 | $86.98 |