- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.02 / $166.43 / $9,369.62
| Facility | | $48.02 | $166.43 | $9,369.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.55 / $48.02 / $52.82
| Professional | | $47.55 | $48.02 | $52.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.55 / $95.10 / $115.07
| Facility | | $47.55 | $95.10 | $115.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.27 / $47.55 / $61.44
| Professional | | $43.27 | $47.55 | $61.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.28 / $47.55 / $71.33
| Facility | | $43.28 | $47.55 | $71.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.55 / $47.55 / $59.44
| Professional | | $47.55 | $47.55 | $59.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.55 / $47.55 / $47.55
| Facility | | $47.55 | $47.55 | $47.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.55 / $47.55 / $52.00
| Professional | | $47.55 | $47.55 | $52.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.55 / $50.40 / $60.87
| Professional | | $47.55 | $50.40 | $60.87 |