- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.02 / $0.05
| Facility | | $0.02 | $0.02 | $0.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.00 / $310.00 / $310.00
| Professional | | $46.00 | $310.00 | $310.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.51 / $10.51 / $10.51
| Professional | | $10.51 | $10.51 | $10.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.50 / $11.08 / $24.26
| Professional | | $8.50 | $11.08 | $24.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.74 / $21.23 / $21.23
| Facility | | $12.74 | $21.23 | $21.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.57 / $21.23 / $21.23
| Professional | | $3.57 | $21.23 | $21.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.50 / $29.35 / $36.69
| Professional | | $28.50 | $29.35 | $36.69 |
- 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
- $5.05 / $5.05 / $5.05
| Facility | | $5.05 | $5.05 | $5.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $5.05 / $6.45
| Professional | | $5.05 | $5.05 | $6.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.73 / $254.50 / $74,999.25
| Facility | | $13.73 | $254.50 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.66 / $22.66 / $35.61
| Professional | | $22.66 | $22.66 | $35.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.30 / $24.30 / $24.30
| Facility | | $24.30 | $24.30 | $24.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.45 / $6.45 / $24.30
| Professional | | $6.45 | $6.45 | $24.30 |