- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.40 / $40.40 / $156.35
| Facility | | $40.40 | $40.40 | $156.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.72 / $47.27 / $60.26
| Professional | | $33.72 | $47.27 | $60.26 |
- 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
- $74.73 / $98.16 / $98.16
| Professional | | $74.73 | $98.16 | $98.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.85 / $53.85 / $86.18
| Facility | | $53.85 | $53.85 | $86.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.31 / $39.31 / $116.25
| Professional | | $39.31 | $39.31 | $116.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.29 / $86.18 / $163.74
| Professional | | $79.29 | $86.18 | $163.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $259.62 / $259.62 / $259.62
| Facility | | $259.62 | $259.62 | $259.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.40 / $40.40 / $156.35
| Facility | | $40.40 | $40.40 | $156.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.72 / $50.71 / $143.88
| Professional | | $33.72 | $50.71 | $143.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.80 / $40.50 / $148.18
| Professional | | $30.80 | $40.50 | $148.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.85 / $53.85 / $86.18
| Facility | | $53.85 | $53.85 | $86.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.31 / $39.31 / $116.25
| Professional | | $39.31 | $39.31 | $116.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.19 / $93.43 / $93.43
| Facility | | $70.19 | $93.43 | $93.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.19 / $93.43 / $95.33
| Professional | | $70.19 | $93.43 | $95.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.44 / $49.51 / $86.18
| Professional | | $36.44 | $49.51 | $86.18 |