- 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
- $11.11 / $17.28 / $39.69
| Professional | | $11.11 | $17.28 | $39.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.69 / $54.50 / $95.95
| Facility | | $25.69 | $54.50 | $95.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.80 / $18.80 / $20.89
| Professional | | $18.80 | $18.80 | $20.89 |
- 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 / $20.23 / $107.77
| Professional | | $14.57 | $20.23 | $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
- $13.12 / $18.18 / $50.44
| Professional | | $13.12 | $18.18 | $50.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.75 / $30.75 / $117.35
| Facility | | $30.75 | $30.75 | $117.35 |
- 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 / $39.69
| Professional | | $10.77 | $17.28 | $39.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.35 / $24.10 / $178.91
| Facility | | $11.35 | $24.10 | $178.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.11 / $17.21 / $39.69
| Professional | | $11.11 | $17.21 | $39.69 |