- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.40 / $39.40 / $152.47
| Facility | | $39.40 | $39.40 | $152.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.46 / $43.59 / $60.35
| Professional | | $37.46 | $43.59 | $60.35 |
- 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
- $72.89 / $95.72 / $95.72
| Professional | | $72.89 | $95.72 | $95.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.58 / $66.58 / $95.72
| Facility | | $66.58 | $66.58 | $95.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.60 / $48.60 / $83.82
| Professional | | $48.60 | $48.60 | $83.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.06 / $95.72 / $181.87
| Professional | | $88.06 | $95.72 | $181.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.63 / $64.63 / $68.20
| Professional | | $64.63 | $64.63 | $68.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.40 / $39.40 / $152.47
| Facility | | $39.40 | $39.40 | $152.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.46 / $46.10 / $86.35
| Professional | | $37.46 | $46.10 | $86.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.70 / $136.50 / $188.60
| Professional | | $118.70 | $136.50 | $188.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.58 / $66.58 / $95.72
| Facility | | $66.58 | $66.58 | $95.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.60 / $48.60 / $113.63
| Professional | | $48.60 | $48.60 | $113.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.44 / $91.11 / $91.11
| Facility | | $68.44 | $91.11 | $91.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.44 / $91.11 / $93.36
| Professional | | $68.44 | $91.11 | $93.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.43 / $47.75 / $83.63
| Professional | | $36.43 | $47.75 | $83.63 |