- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.21 / $33.21 / $918.46
| Facility | | $33.21 | $33.21 | $918.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.11 / $35.15 / $45.31
| Professional | | $29.11 | $35.15 | $45.31 |
- 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
- $56.62 / $74.34 / $74.34
| Professional | | $56.62 | $74.34 | $74.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.76 / $43.76 / $74.34
| Facility | | $43.76 | $43.76 | $74.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.20 / $37.20 / $88.50
| Professional | | $37.20 | $37.20 | $88.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.40 / $74.34 / $141.27
| Professional | | $68.40 | $74.34 | $141.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.21 / $33.21 / $918.46
| Facility | | $33.21 | $33.21 | $918.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.11 / $35.15 / $51.25
| Professional | | $29.11 | $35.15 | $51.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.20 / $106.00 / $146.50
| Professional | | $92.20 | $106.00 | $146.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.76 / $43.76 / $74.34
| Facility | | $43.76 | $43.76 | $74.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.20 / $37.20 / $88.50
| Professional | | $37.20 | $37.20 | $88.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.17 / $70.77 / $70.77
| Facility | | $53.17 | $70.77 | $70.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.17 / $70.77 / $72.54
| Professional | | $53.17 | $70.77 | $72.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.96 / $44.61 / $64.97
| Professional | | $33.96 | $44.61 | $64.97 |