- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.07 / $272.44 / $1,631.20
| Facility | | $55.07 | $272.44 | $1,631.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.08 / $53.61 / $182.00
| Professional | | $53.08 | $53.61 | $182.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.49 / $57.33 / $11,992.50
| Facility | | $47.49 | $57.33 | $11,992.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.94 / $57.58 / $8,639.91
| Facility | | $48.94 | $57.58 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.08 / $55.08 / $55.08
| Professional | | $55.08 | $55.08 | $55.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.49 / $47.49 / $47.49
| Facility | | $47.49 | $47.49 | $47.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.49 / $47.49 / $47.49
| Professional | | $47.49 | $47.49 | $47.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.82 / $131.91 / $726.24
| Facility | | $45.82 | $131.91 | $726.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.49 / $55.80 / $9,169.65
| Facility | | $47.49 | $55.80 | $9,169.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.08 / $194.21 / $1,358.78
| Facility | | $68.08 | $194.21 | $1,358.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.08 / $53.61 / $161.36
| Professional | | $53.08 | $53.61 | $161.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.49 / $47.49 / $47.49
| Facility | | $47.49 | $47.49 | $47.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.49 / $47.49 / $47.49
| Professional | | $47.49 | $47.49 | $47.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.77 / $52.77 / $61.24
| Facility | | $52.77 | $52.77 | $61.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.77 / $52.77 / $61.24
| Professional | | $52.77 | $52.77 | $61.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.08 / $53.08 / $74.97
| Professional | | $53.08 | $53.08 | $74.97 |