- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.04 / $56.10
| Facility | | $0.02 | $0.04 | $56.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.00 / $96.00 / $96.00
| Professional | | $96.00 | $96.00 | $96.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.56 / $135.76 / $135.76
| Facility | | $47.56 | $135.76 | $135.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.35 / $15.44 / $39.69
| Professional | | $7.35 | $15.44 | $39.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.59 / $52.96 / $95.95
| Facility | | $19.59 | $52.96 | $95.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.82 / $13.82 / $13.82
| Professional | | $13.82 | $13.82 | $13.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.56 / $0.99 / $1.65
| Facility | | $0.56 | $0.99 | $1.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.57 / $15.69 / $107.77
| Professional | | $14.57 | $15.69 | $107.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.54 / $34.54 / $40.64
| Professional | | $34.54 | $34.54 | $40.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.21 / $15.54 / $43.37
| Professional | | $11.21 | $15.54 | $43.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.15 / $58.19 / $74.75
| Facility | | $25.15 | $58.19 | $74.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.56 / $135.76 / $135.76
| Facility | | $47.56 | $135.76 | $135.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.35 / $15.44 / $39.69
| Professional | | $7.35 | $15.44 | $39.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.24 / $15.62 / $23.54
| Professional | | $9.24 | $15.62 | $23.54 |