- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.81 / $319.27 / $319.27
| Facility | | $30.81 | $319.27 | $319.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.50 / $51.59 / $74.29
| Professional | | $36.50 | $51.59 | $74.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.21 / $102.21 / $102.21
| Professional | | $102.21 | $102.21 | $102.21 |
- 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
- $86.28 / $113.31 / $113.31
| Professional | | $86.28 | $113.31 | $113.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.80 / $70.80 / $115.96
| Facility | | $70.80 | $70.80 | $115.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.68 / $51.68 / $131.25
| Professional | | $51.68 | $51.68 | $131.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.68 / $115.96 / $220.32
| Professional | | $106.68 | $115.96 | $220.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.12 / $30.12 / $34.60
| Facility | | $30.12 | $30.12 | $34.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.51 / $80.75 / $90.65
| Professional | | $76.51 | $80.75 | $90.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.89 / $319.27 / $319.27
| Facility | | $14.89 | $319.27 | $319.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.50 / $51.29 / $92.76
| Professional | | $36.50 | $51.29 | $92.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.00 / $78.50 / $228.50
| Professional | | $37.00 | $78.50 | $228.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.80 / $70.80 / $115.96
| Facility | | $70.80 | $70.80 | $115.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.68 / $51.68 / $131.25
| Professional | | $51.68 | $51.68 | $131.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.34 / $107.85 / $107.85
| Facility | | $78.34 | $107.85 | $107.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.34 / $107.85 / $110.37
| Professional | | $78.34 | $107.85 | $110.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.38 / $56.77 / $99.00
| Professional | | $47.38 | $56.77 | $99.00 |