- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.90 / $70.90 / $274.38
| Facility | | $70.90 | $70.90 | $274.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.66 / $78.44 / $99.89
| Professional | | $55.66 | $78.44 | $99.89 |
- 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
- $131.18 / $172.27 / $172.27
| Professional | | $131.18 | $172.27 | $172.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.16 / $85.16 / $142.24
| Facility | | $85.16 | $85.16 | $142.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.17 / $62.17 / $183.32
| Professional | | $62.17 | $62.17 | $183.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.86 / $142.24 / $270.26
| Professional | | $130.86 | $142.24 | $270.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.33 / $116.33 / $129.19
| Professional | | $116.33 | $116.33 | $129.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.90 / $70.90 / $274.38
| Facility | | $70.90 | $70.90 | $274.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.66 / $79.92 / $274.38
| Professional | | $55.66 | $79.92 | $274.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.30 / $185.20 / $280.20
| Professional | | $96.30 | $185.20 | $280.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.16 / $85.16 / $142.24
| Facility | | $85.16 | $85.16 | $142.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.17 / $62.17 / $226.88
| Professional | | $62.17 | $62.17 | $226.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.17 / $163.97 / $163.97
| Facility | | $123.17 | $163.97 | $163.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.17 / $163.97 / $163.97
| Professional | | $123.17 | $163.97 | $163.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.30 / $85.94 / $143.24
| Professional | | $57.30 | $85.94 | $143.24 |