- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.77 / $22.77 / $88.12
| Facility | | $22.77 | $22.77 | $88.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.66 / $26.65 / $33.46
| Professional | | $21.66 | $26.65 | $33.46 |
- 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
- $42.14 / $55.34 / $55.34
| Professional | | $42.14 | $55.34 | $55.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.65 / $31.65 / $55.34
| Facility | | $31.65 | $31.65 | $55.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.10 / $23.10 / $48.45
| Professional | | $23.10 | $23.10 | $48.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.91 / $55.34 / $105.15
| Professional | | $50.91 | $55.34 | $105.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.77 / $22.77 / $88.12
| Facility | | $22.77 | $22.77 | $88.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.66 / $28.59 / $34.97
| Professional | | $21.66 | $28.59 | $34.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.70 / $75.50 / $109.00
| Professional | | $21.70 | $75.50 | $109.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.65 / $31.65 / $55.34
| Facility | | $31.65 | $31.65 | $55.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.10 / $23.10 / $65.63
| Professional | | $23.10 | $23.10 | $65.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.56 / $52.67 / $52.67
| Facility | | $39.56 | $52.67 | $52.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.56 / $52.67 / $53.98
| Professional | | $39.56 | $52.67 | $53.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.47 / $25.04 / $29.25
| Facility | | $19.47 | $25.04 | $29.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.06 / $27.61 / $48.35
| Professional | | $21.06 | $27.61 | $48.35 |