- 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
- $135.00 / $135.00 / $135.00
| Professional | | $135.00 | $135.00 | $135.00 |
- 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 / $42.49
| Professional | | $11.52 | $17.28 | $42.49 |
- 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 / $24.78 / $107.77
| Professional | | $14.57 | $24.78 | $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
- $14.18 / $18.72 / $60.09
| Professional | | $14.18 | $18.72 | $60.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.13 / $35.67 / $133.97
| Facility | | $13.13 | $35.67 | $133.97 |
- 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 / $42.49
| Professional | | $10.77 | $17.28 | $42.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.93 / $17.28 / $41.49
| Professional | | $9.93 | $17.28 | $41.49 |