- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.09 / $3,891.11 / $9,716.49
| Facility | | $31.09 | $3,891.11 | $9,716.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.09 / $32.33 / $7,056.00
| Professional | | $31.09 | $32.33 | $7,056.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.99 / $53.57 / $218.60
| Facility | | $21.99 | $53.57 | $218.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.98 / $40.09 / $96.52
| Professional | | $19.98 | $40.09 | $96.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.45 / $25.51 / $54.37
| Facility | | $21.45 | $25.51 | $54.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.98 / $19.98 / $19.98
| Facility | | $19.98 | $19.98 | $19.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.98 / $19.98 / $19.98
| Professional | | $19.98 | $19.98 | $19.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.07 / $53.00 / $8,090.00
| Facility | | $20.07 | $53.00 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.88 / $22.88 / $26.91
| Professional | | $22.88 | $22.88 | $26.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.98 / $19.98 / $66.40
| Professional | | $19.98 | $19.98 | $66.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.18 / $1,219.53 / $8,947.17
| Facility | | $375.18 | $1,219.53 | $8,947.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.55 / $113.55 / $218.60
| Facility | | $113.55 | $113.55 | $218.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.09 / $40.09 / $96.52
| Professional | | $40.09 | $40.09 | $96.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.99 / $35.99 / $35.99
| Facility | | $35.99 | $35.99 | $35.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.09 / $40.09 / $96.52
| Professional | | $40.09 | $40.09 | $96.52 |