- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.02 / $40.02 / $154.88
| Facility | | $40.02 | $40.02 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.61 / $46.83 / $63.23
| Professional | | $36.61 | $46.83 | $63.23 |
- 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
- $74.04 / $97.24 / $97.24
| Professional | | $74.04 | $97.24 | $97.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.69 / $62.81 / $107.55
| Facility | | $56.69 | $62.81 | $107.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.85 / $45.85 / $94.18
| Professional | | $45.85 | $45.85 | $94.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.95 / $107.55 / $204.35
| Professional | | $98.95 | $107.55 | $204.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.93 / $72.93 / $72.93
| Professional | | $72.93 | $72.93 | $72.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.02 / $40.02 / $154.88
| Facility | | $40.02 | $40.02 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.75 / $46.82 / $83.82
| Professional | | $31.75 | $46.82 | $83.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.90 / $47.20 / $211.90
| Professional | | $35.90 | $47.20 | $211.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.69 / $62.81 / $107.55
| Facility | | $56.69 | $62.81 | $107.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.85 / $45.85 / $114.38
| Professional | | $45.85 | $45.85 | $114.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.23 / $92.55 / $92.55
| Facility | | $67.23 | $92.55 | $92.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.23 / $92.55 / $102.37
| Professional | | $67.23 | $92.55 | $102.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.57 / $48.51 / $84.96
| Professional | | $39.57 | $48.51 | $84.96 |