- 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
- $237.00 / $237.00 / $237.00
| Professional | | $237.00 | $237.00 | $237.00 |
- 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
- $11.52 / $17.28 / $47.66
| Professional | | $11.52 | $17.28 | $47.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.38 / $54.88 / $102.94
| Facility | | $36.38 | $54.88 | $102.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.89 / $24.89 / $24.89
| Professional | | $24.89 | $24.89 | $24.89 |
- 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 / $28.91 / $107.77
| Professional | | $14.57 | $28.91 | $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
- $17.00 / $23.56 / $60.09
| Professional | | $17.00 | $23.56 | $60.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.49 / $75.59 / $358.69
| Facility | | $26.49 | $75.59 | $358.69 |
- 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 / $47.66
| Professional | | $10.77 | $17.28 | $47.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.68 / $17.28 / $46.53
| Professional | | $10.68 | $17.28 | $46.53 |