- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.04 / $59.50
| Facility | | $0.02 | $0.04 | $59.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.00 / $146.00 / $146.00
| Professional | | $146.00 | $146.00 | $146.00 |
- 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 / $44.22
| Professional | | $11.52 | $17.28 | $44.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.25 / $54.88 / $95.95
| Facility | | $33.25 | $54.88 | $95.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.89 / $25.89 / $25.89
| Professional | | $25.89 | $25.89 | $25.89 |
- 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 / $18.17 / $107.77
| Professional | | $14.57 | $18.17 | $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
- $11.46 / $15.13 / $62.49
| Professional | | $11.46 | $15.13 | $62.49 |
- 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 / $44.22
| Professional | | $10.77 | $17.28 | $44.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.92 / $14.55 / $29.45
| Facility | | $9.92 | $14.55 | $29.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.68 / $17.28 / $43.17
| Professional | | $10.68 | $17.28 | $43.17 |