- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.58 / $73.58 / $284.76
| Facility | | $73.58 | $73.58 | $284.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.42 / $77.91 / $100.55
| Professional | | $62.42 | $77.91 | $100.55 |
- 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
- $125.46 / $164.77 / $164.77
| Professional | | $125.46 | $164.77 | $164.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.66 / $99.66 / $159.47
| Facility | | $99.66 | $99.66 | $159.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.75 / $72.75 / $139.65
| Professional | | $72.75 | $72.75 | $139.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.72 / $159.47 / $303.01
| Professional | | $146.72 | $159.47 | $303.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.58 / $123.58 / $123.58
| Professional | | $123.58 | $123.58 | $123.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.58 / $73.58 / $284.76
| Facility | | $73.58 | $73.58 | $284.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.42 / $77.91 / $133.91
| Professional | | $62.42 | $77.91 | $133.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.00 / $217.50 / $314.20
| Professional | | $108.00 | $217.50 | $314.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.66 / $99.66 / $159.47
| Facility | | $99.66 | $99.66 | $159.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.75 / $72.75 / $184.88
| Professional | | $72.75 | $72.75 | $184.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.73 / $78.73 / $156.83
| Facility | | $78.73 | $78.73 | $156.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.73 / $151.80 / $156.83
| Professional | | $78.73 | $151.80 | $156.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.08 / $98.67 / $148.61
| Professional | | $77.08 | $98.67 | $148.61 |