- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.93 / $45.80 / $177.25
| Facility | | $43.93 | $45.80 | $177.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.36 / $46.47 / $61.87
| Professional | | $43.36 | $46.47 | $61.87 |
- 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
- $96.60 / $100.24 / $100.24
| Professional | | $96.60 | $100.24 | $100.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.84 / $69.84 / $69.84
| Facility | | $69.84 | $69.84 | $69.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.99 / $50.99 / $74.52
| Professional | | $50.99 | $50.99 | $74.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.40 / $142.40 / $142.40
| Professional | | $142.40 | $142.40 | $142.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.80 / $45.80 / $177.25
| Facility | | $45.80 | $45.80 | $177.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.24 / $46.47 / $92.29
| Professional | | $43.24 | $46.47 | $92.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.60 / $117.60 / $117.60
| Professional | | $117.60 | $117.60 | $117.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.84 / $69.84 / $69.84
| Facility | | $69.84 | $69.84 | $69.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.99 / $50.99 / $98.63
| Professional | | $50.99 | $50.99 | $98.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.00 / $68.00 / $68.00
| Facility | | $68.00 | $68.00 | $68.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.00 / $68.00 / $68.00
| Professional | | $68.00 | $68.00 | $68.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.78 / $58.49 / $107.69
| Professional | | $46.78 | $58.49 | $107.69 |