- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.02 / $0.04
| Facility | | $0.02 | $0.02 | $0.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.00 / $106.00 / $106.00
| Professional | | $106.00 | $106.00 | $106.00 |
- 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
- $10.21 / $17.23 / $39.69
| Professional | | $10.21 | $17.23 | $39.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.47 / $54.88 / $98.07
| Facility | | $34.47 | $54.88 | $98.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.38 / $19.38 / $19.38
| Professional | | $19.38 | $19.38 | $19.38 |
- 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 / $22.30 / $107.77
| Professional | | $14.57 | $22.30 | $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
- $12.20 / $16.91 / $52.30
| Professional | | $12.20 | $16.91 | $52.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.87 / $32.97 / $208.65
| Facility | | $25.87 | $32.97 | $208.65 |
- 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
- $10.21 / $17.23 / $39.69
| Professional | | $10.21 | $17.23 | $39.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.55 / $22.40 / $178.28
| Facility | | $10.55 | $22.40 | $178.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.21 / $15.44 / $39.69
| Professional | | $10.21 | $15.44 | $39.69 |