- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.55 / $46.55 / $180.15
| Facility | | $46.55 | $46.55 | $180.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.26 / $54.47 / $68.34
| Professional | | $44.26 | $54.47 | $68.34 |
- 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
- $86.13 / $113.11 / $113.11
| Professional | | $86.13 | $113.11 | $113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.66 / $64.66 / $113.11
| Facility | | $64.66 | $64.66 | $113.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.20 / $47.20 / $99.04
| Professional | | $47.20 | $47.20 | $99.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.06 / $113.11 / $214.91
| Professional | | $104.06 | $113.11 | $214.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.36 / $76.36 / $84.83
| Professional | | $76.36 | $76.36 | $84.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.55 / $46.55 / $180.15
| Facility | | $46.55 | $46.55 | $180.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.26 / $54.47 / $71.31
| Professional | | $44.26 | $54.47 | $71.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.79 / $49.60 / $222.80
| Professional | | $37.79 | $49.60 | $222.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.66 / $64.66 / $113.11
| Facility | | $64.66 | $64.66 | $113.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.20 / $47.20 / $134.25
| Professional | | $47.20 | $47.20 | $134.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.84 / $107.66 / $107.66
| Facility | | $80.84 | $107.66 | $107.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.84 / $107.66 / $110.21
| Professional | | $80.84 | $107.66 | $110.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.02 / $56.64 / $101.96
| Professional | | $43.02 | $56.64 | $101.96 |