- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.28 / $48.28 / $186.84
| Facility | | $48.28 | $48.28 | $186.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.44 / $51.26 / $60.61
| Professional | | $34.44 | $51.26 | $60.61 |
- 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
- $89.34 / $117.32 / $117.32
| Professional | | $89.34 | $117.32 | $117.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.90 / $65.90 / $87.99
| Facility | | $65.90 | $65.90 | $87.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.11 / $48.11 / $77.05
| Professional | | $48.11 | $48.11 | $77.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.95 / $87.99 / $167.18
| Professional | | $80.95 | $87.99 | $167.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.83 / $678.83 / $678.83
| Facility | | $678.83 | $678.83 | $678.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.22 / $79.22 / $82.12
| Professional | | $79.22 | $79.22 | $82.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.28 / $48.28 / $186.84
| Facility | | $48.28 | $48.28 | $186.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.43 / $53.42 / $186.84
| Professional | | $34.43 | $53.42 | $186.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.60 / $114.60 / $173.40
| Professional | | $59.60 | $114.60 | $173.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.90 / $65.90 / $87.99
| Facility | | $65.90 | $65.90 | $87.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.11 / $48.11 / $114.00
| Professional | | $48.11 | $48.11 | $114.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.52 / $111.67 / $111.67
| Facility | | $75.52 | $111.67 | $111.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.52 / $111.67 / $111.67
| Professional | | $75.52 | $111.67 | $111.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.64 / $58.53 / $92.48
| Professional | | $39.64 | $58.53 | $92.48 |