- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.05 / $0.05
| Facility | | $0.02 | $0.05 | $0.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.44 / $15.44 / $15.44
| Professional | | $15.44 | $15.44 | $15.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.36 / $4.36 / $10.67
| Professional | | $4.36 | $4.36 | $10.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.06 / $14.06 / $14.06
| Professional | | $14.06 | $14.06 | $14.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.75 / $28.91 / $36.14
| Professional | | $17.75 | $28.91 | $36.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $5.05 / $5.05
| Professional | | $5.05 | $5.05 | $5.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.92 / $106.51 / $729.50
| Facility | | $7.92 | $106.51 | $729.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.62 / $12.62 / $12.62
| Professional | | $12.62 | $12.62 | $12.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.03 / $0.05
| Facility | | $0.02 | $0.03 | $0.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.02 / $0.03 / $15.44
| Professional | | $0.02 | $0.03 | $15.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.29 / $28.91 / $36.14
| Professional | | $23.29 | $28.91 | $36.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.69 / $14.69 / $14.69
| Facility | | $14.69 | $14.69 | $14.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.19 / $14.63 / $37.77
| Professional | | $10.19 | $14.63 | $37.77 |