- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.35 / $39.67 / $400.09
| Facility | | $20.35 | $39.67 | $400.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.35 / $20.35 / $28.55
| Professional | | $20.35 | $20.35 | $28.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.29 / $67.42 / $628.59
| Facility | | $54.29 | $67.42 | $628.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.35 / $21.37 / $573.77
| Professional | | $20.35 | $21.37 | $573.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.82 / $24.99 / $48.56
| Facility | | $21.82 | $24.99 | $48.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.35 / $28.74 / $105.86
| Professional | | $20.35 | $28.74 | $105.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.35 / $20.35 / $46.35
| Facility | | $20.35 | $20.35 | $46.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.35 / $20.35 / $27.63
| Professional | | $20.35 | $20.35 | $27.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $56.54 / $8,090.00
| Facility | | $28.84 | $56.54 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.35 / $20.35 / $20.35
| Professional | | $20.35 | $20.35 | $20.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.35 / $20.35 / $23.55
| Professional | | $20.35 | $20.35 | $23.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.71 / $646.63 / $1,985.06
| Facility | | $121.71 | $646.63 | $1,985.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.45 / $628.59 / $628.59
| Facility | | $272.45 | $628.59 | $628.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.35 / $21.57 / $573.77
| Professional | | $20.35 | $21.57 | $573.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.35 / $21.57 / $48.03
| Professional | | $20.35 | $21.57 | $48.03 |