- 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
- $125.00 / $125.00 / $125.00
| Professional | | $125.00 | $125.00 | $125.00 |
- 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
- $8.96 / $15.44 / $39.69
| Professional | | $8.96 | $15.44 | $39.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.33 / $53.73 / $95.95
| Facility | | $25.33 | $53.73 | $95.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.09 / $18.09 / $18.09
| Professional | | $18.09 | $18.09 | $18.09 |
- 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 / $19.41 / $107.77
| Professional | | $14.57 | $19.41 | $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
- $9.18 / $12.72 / $51.20
| Professional | | $9.18 | $12.72 | $51.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.49 / $143.18 / $167.91
| Facility | | $26.49 | $143.18 | $167.91 |
- 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
- $8.96 / $15.44 / $39.69
| Professional | | $8.96 | $15.44 | $39.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.18 / $15.11 / $28.04
| Professional | | $9.18 | $15.11 | $28.04 |