- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.37 / $69.37 / $268.45
| Facility | | $69.37 | $69.37 | $268.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.97 / $79.70 / $101.92
| Professional | | $65.97 | $79.70 | $101.92 |
- 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
- $128.35 / $168.56 / $168.56
| Professional | | $128.35 | $168.56 | $168.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.24 / $104.24 / $168.56
| Facility | | $104.24 | $104.24 | $168.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.09 / $76.09 / $147.60
| Professional | | $76.09 | $76.09 | $147.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.08 / $168.56 / $320.26
| Professional | | $155.08 | $168.56 | $320.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.83 / $113.83 / $126.42
| Professional | | $113.83 | $113.83 | $126.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.37 / $69.37 / $268.45
| Facility | | $69.37 | $69.37 | $268.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.97 / $81.18 / $152.05
| Professional | | $65.97 | $81.18 | $152.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.30 / $74.00 / $332.10
| Professional | | $56.30 | $74.00 | $332.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.24 / $104.24 / $168.56
| Facility | | $104.24 | $104.24 | $168.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.09 / $76.09 / $200.25
| Professional | | $76.09 | $76.09 | $200.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.52 / $160.44 / $160.44
| Facility | | $120.52 | $160.44 | $160.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.52 / $160.44 / $164.40
| Professional | | $120.52 | $160.44 | $164.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.77 / $84.10 / $147.28
| Professional | | $63.77 | $84.10 | $147.28 |