- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.80 / $72.80 / $88.24
| Facility | | $22.80 | $72.80 | $88.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.30 / $32.67 / $65.11
| Professional | | $21.30 | $32.67 | $65.11 |
- 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
- $42.18 / $55.40 / $55.40
| Professional | | $42.18 | $55.40 | $55.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.61 / $36.61 / $54.42
| Facility | | $36.61 | $36.61 | $54.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.73 / $26.73 / $47.65
| Professional | | $26.73 | $26.73 | $47.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.07 / $54.42 / $103.40
| Professional | | $50.07 | $54.42 | $103.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.89 / $115.67 / $125.00
| Facility | | $109.89 | $115.67 | $125.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.40 / $37.40 / $58.17
| Professional | | $37.40 | $37.40 | $58.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.48 / $82.31 / $88.24
| Facility | | $70.48 | $82.31 | $88.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.67 / $32.67 / $100.00
| Professional | | $22.67 | $32.67 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.50 / $25.60 / $107.20
| Professional | | $19.50 | $25.60 | $107.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.61 / $36.61 / $54.42
| Facility | | $36.61 | $36.61 | $54.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.73 / $26.73 / $83.63
| Professional | | $26.73 | $26.73 | $83.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.86 / $52.73 / $52.73
| Facility | | $36.86 | $52.73 | $52.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.86 / $52.73 / $68.56
| Professional | | $36.86 | $52.73 | $68.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.47 / $28.16 / $49.96
| Professional | | $22.47 | $28.16 | $49.96 |