- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $54.95 / $54.95
| Facility | | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $69.18 / $275.42
| Professional | | $41.69 | $69.18 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $151.36 / $478.63
| Facility | | $100.00 | $151.36 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $97.72 / $128.82
| Professional | | $47.86 | $97.72 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $67.61 / $204.17
| Facility | | $67.61 | $67.61 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $114.82 / $151.36
| Professional | | $83.18 | $114.82 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $61.66 / $61.66
| Facility | | $60.26 | $61.66 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $44.67 / $64.57
| Professional | | $44.67 | $44.67 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $112.20 / $169.82
| Professional | | $112.20 | $112.20 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.12 / $25.12 / $25.12
| Facility | | $25.12 | $25.12 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $79.43
| Professional | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $151.36 / $478.63
| Facility | | $100.00 | $151.36 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $97.72 / $131.83
| Professional | | $47.86 | $97.72 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Professional | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.08 / $60.26 / $131.83
| Facility | | $0.08 | $60.26 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $79.43 / $112.20
| Professional | | $47.86 | $79.43 | $112.20 |