- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.78 / $40.78 / $157.82
| Facility | | $40.78 | $40.78 | $157.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.97 / $43.18 / $52.85
| Professional | | $35.97 | $43.18 | $52.85 |
- 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
- $69.54 / $91.32 / $91.32
| Professional | | $69.54 | $91.32 | $91.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.87 / $59.87 / $94.39
| Facility | | $59.87 | $59.87 | $94.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.71 / $43.71 / $82.65
| Professional | | $43.71 | $43.71 | $82.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.84 / $94.39 / $179.34
| Professional | | $86.84 | $94.39 | $179.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $61.66 / $61.66
| Professional | | $61.66 | $61.66 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.78 / $40.78 / $157.82
| Facility | | $40.78 | $40.78 | $157.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.70 / $44.78 / $74.22
| Professional | | $35.70 | $44.78 | $74.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.80 / $128.69 / $186.00
| Professional | | $63.80 | $128.69 | $186.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.87 / $59.87 / $94.39
| Facility | | $59.87 | $59.87 | $94.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.71 / $43.71 / $107.25
| Professional | | $43.71 | $43.71 | $107.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.14 / $63.14 / $86.92
| Facility | | $63.14 | $63.14 | $86.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.14 / $86.92 / $89.84
| Professional | | $63.14 | $86.92 | $89.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.92 / $54.79 / $82.34
| Professional | | $41.92 | $54.79 | $82.34 |