- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.85 / $37.34 / $13,535.44
| Facility | | $27.85 | $37.34 | $13,535.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.85 / $28.96 / $31.80
| Professional | | $27.85 | $28.96 | $31.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.64 / $74.64 / $354.50
| Facility | | $30.64 | $74.64 | $354.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.85 / $29.52 / $73.12
| Professional | | $27.85 | $29.52 | $73.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.88 / $35.54 / $75.75
| Facility | | $29.88 | $35.54 | $75.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.59 / $27.85 / $27.85
| Facility | | $23.59 | $27.85 | $27.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.85 / $27.85 / $27.85
| Professional | | $27.85 | $27.85 | $27.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.85 / $53.00 / $8,090.00
| Facility | | $27.85 | $53.00 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.94 / $35.94 / $42.29
| Professional | | $35.94 | $35.94 | $42.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.85 / $27.85 / $57.84
| Professional | | $27.85 | $27.85 | $57.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,180.17 / $2,193.51 / $20,164.90
| Facility | | $1,180.17 | $2,193.51 | $20,164.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.02 / $86.02 / $354.50
| Facility | | $86.02 | $86.02 | $354.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.85 / $29.52 / $73.12
| Professional | | $27.85 | $29.52 | $73.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.22 / $46.22 / $63.11
| Facility | | $46.22 | $46.22 | $63.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.85 / $29.52 / $73.12
| Professional | | $27.85 | $29.52 | $73.12 |