- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.73 / $334.44 / $975.52
| Facility | | $77.73 | $334.44 | $975.52 |
- 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 / $3,293.03 / $7,050.54
| Facility | | $47.49 | $3,293.03 | $7,050.54 |
- 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
- $45.90 / $45.90 / $45.90
| Facility | | $45.90 | $45.90 | $45.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.90 / $45.90 / $45.90
| Professional | | $45.90 | $45.90 | $45.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.17 / $177.53 / $532.51
| Facility | | $46.17 | $177.53 | $532.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.49 / $4,172.00 / $7,050.54
| Facility | | $47.49 | $4,172.00 | $7,050.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.73 / $304.64 / $975.52
| Facility | | $77.73 | $304.64 | $975.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.08 / $55.07 / $161.36
| Professional | | $53.08 | $55.07 | $161.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.90 / $45.90 / $45.90
| Facility | | $45.90 | $45.90 | $45.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.90 / $45.90 / $45.90
| Professional | | $45.90 | $45.90 | $45.90 |
- 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 / $69.27
| Professional | | $53.08 | $53.08 | $69.27 |