- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.63 / $24.63 / $95.32
| Facility | | $24.63 | $24.63 | $95.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.43 / $27.25 / $34.70
| Professional | | $23.43 | $27.25 | $34.70 |
- 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
- $45.57 / $59.84 / $59.84
| Professional | | $45.57 | $59.84 | $59.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.72 / $36.72 / $59.84
| Facility | | $36.72 | $36.72 | $59.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.81 / $26.81 / $52.40
| Professional | | $26.81 | $26.81 | $52.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.05 / $59.84 / $113.70
| Professional | | $55.05 | $59.84 | $113.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.63 / $24.63 / $95.32
| Facility | | $24.63 | $24.63 | $95.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.43 / $28.30 / $47.87
| Professional | | $23.43 | $28.30 | $47.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.40 / $85.40 / $117.90
| Professional | | $62.40 | $85.40 | $117.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.72 / $36.72 / $59.84
| Facility | | $36.72 | $36.72 | $59.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.81 / $26.81 / $70.88
| Professional | | $26.81 | $26.81 | $70.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.80 / $56.96 / $56.96
| Facility | | $42.80 | $56.96 | $56.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.80 / $56.96 / $58.33
| Professional | | $42.80 | $56.96 | $58.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.62 / $29.98 / $52.29
| Professional | | $22.62 | $29.98 | $52.29 |