- 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
- $116.00 / $116.00 / $116.00
| Professional | | $116.00 | $116.00 | $116.00 |
- 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
- $17.35 / $52.96 / $95.95
| Facility | | $17.35 | $52.96 | $95.95 |
- 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 / $24.37 / $107.77
| Professional | | $14.57 | $24.37 | $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
- $13.80 / $19.13 / $71.47
| Professional | | $13.80 | $19.13 | $71.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.16 / $18.16 / $25.87
| Facility | | $18.16 | $18.16 | $25.87 |
- 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 / $17.32 / $46.53
| Professional | | $10.68 | $17.32 | $46.53 |