- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.08 / $46.08 / $178.33
| Facility | | $46.08 | $46.08 | $178.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.40 / $51.11 / $73.95
| Professional | | $40.40 | $51.11 | $73.95 |
- 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
- $85.26 / $111.97 / $111.97
| Professional | | $85.26 | $111.97 | $111.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.52 / $64.52 / $103.26
| Facility | | $64.52 | $64.52 | $103.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.10 / $47.10 / $90.42
| Professional | | $47.10 | $47.10 | $90.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.00 / $103.26 / $196.19
| Professional | | $95.00 | $103.26 | $196.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.08 / $46.08 / $178.33
| Facility | | $46.08 | $46.08 | $178.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.40 / $52.95 / $79.01
| Professional | | $40.40 | $52.95 | $79.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.90 / $140.80 / $203.40
| Professional | | $69.90 | $140.80 | $203.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.52 / $64.52 / $103.26
| Facility | | $64.52 | $64.52 | $103.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.10 / $47.10 / $159.75
| Professional | | $47.10 | $47.10 | $159.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.06 / $106.58 / $106.58
| Facility | | $80.06 | $106.58 | $106.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.06 / $106.58 / $131.05
| Professional | | $80.06 | $106.58 | $131.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.18 / $55.86 / $100.98
| Professional | | $43.18 | $55.86 | $100.98 |