- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $19.50 / $380.19
| Facility | | $19.50 | $19.50 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $19.05 / $19.05
| Professional | | $18.20 | $19.05 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.57 / $4.57 / $17.78
| Professional | | $4.57 | $4.57 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.92 / $11.48 / $11.48
| Facility | | $6.92 | $11.48 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $11.48 / $11.48
| Professional | | $9.33 | $11.48 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50,118.72
| Facility | | $50.12 | $50.12 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $28.84 / $114.82
| Professional | | $14.45 | $28.84 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.38 / $21.38 / $21.38
| Professional | | $21.38 | $21.38 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.50 / $23.44 / $25.70
| Professional | | $19.50 | $23.44 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $91.20 / $177.83
| Facility | | $70.79 | $91.20 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $13.49 / $16.60
| Facility | | $10.00 | $13.49 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $17.38 / $38.90
| Professional | | $9.77 | $17.38 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $26.30 / $44.67
| Facility | | $19.50 | $26.30 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.50 / $23.44 / $44.67
| Professional | | $19.50 | $23.44 | $44.67 |