- 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
- $148.00 / $148.00 / $148.00
| Professional | | $148.00 | $148.00 | $148.00 |
- 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
- $10.57 / $17.28 / $39.69
| Professional | | $10.57 | $17.28 | $39.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.93 / $52.96 / $95.95
| Facility | | $18.93 | $52.96 | $95.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.88 / $19.88 / $19.88
| Professional | | $19.88 | $19.88 | $19.88 |
- 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 / $21.48 / $107.77
| Professional | | $14.57 | $21.48 | $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
- $10.11 / $14.03 / $47.99
| Professional | | $10.11 | $14.03 | $47.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.89 / $53.70 / $140.02
| Facility | | $35.89 | $53.70 | $140.02 |
- 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
- $10.57 / $17.28 / $39.69
| Professional | | $10.57 | $17.28 | $39.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.24 / $17.28 / $33.08
| Professional | | $9.24 | $17.28 | $33.08 |