- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.38 / $51.65 / $75.65
| Facility | | $15.38 | $51.65 | $75.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.59 / $14.65 / $15.38
| Professional | | $9.59 | $14.65 | $15.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.11 / $14.11 / $14.11
| Professional | | $14.11 | $14.11 | $14.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.89 / $23.52 / $59.76
| Facility | | $11.89 | $23.52 | $59.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.65 / $20.65 / $25.81
| Professional | | $20.65 | $20.65 | $25.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $10.67 / $24.49
| Professional | | $8.32 | $10.67 | $24.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.63 / $49.52 / $75.65
| Facility | | $18.63 | $49.52 | $75.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.87 / $14.83 / $74.70
| Professional | | $11.87 | $14.83 | $74.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.64 / $24.09 / $59.76
| Facility | | $12.64 | $24.09 | $59.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.65 / $20.65 / $25.81
| Professional | | $20.65 | $20.65 | $25.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.09 / $18.09 / $19.89
| Facility | | $18.09 | $18.09 | $19.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.92 / $18.09 / $19.89
| Professional | | $15.92 | $18.09 | $19.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.60 / $7.60 / $7.60
| Facility | | $7.60 | $7.60 | $7.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.60 / $10.85 / $30.75
| Professional | | $7.60 | $10.85 | $30.75 |