- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.04 / $270.66
| Facility | | $0.02 | $0.04 | $270.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.00 / $185.00 / $185.00
| Professional | | $185.00 | $185.00 | $185.00 |
- 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
- $11.52 / $17.28 / $38.54
| Professional | | $11.52 | $17.28 | $38.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.29 / $52.96 / $95.95
| Facility | | $21.29 | $52.96 | $95.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.30 / $30.30 / $30.30
| Professional | | $30.30 | $30.30 | $30.30 |
- 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 / $34.69 / $107.77
| Professional | | $14.57 | $34.69 | $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
- $20.35 / $28.21 / $62.32
| Professional | | $20.35 | $28.21 | $62.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.90 / $53.84 / $225.95
| Facility | | $28.90 | $53.84 | $225.95 |
- 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
- $10.77 / $17.28 / $38.54
| Professional | | $10.77 | $17.28 | $38.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.68 / $17.28 / $37.56
| Professional | | $10.68 | $17.28 | $37.56 |