- 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
- $137.00 / $137.00 / $137.00
| Professional | | $137.00 | $137.00 | $137.00 |
- 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
- $10.75 / $17.28 / $39.69
| Professional | | $10.75 | $17.28 | $39.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.33 / $53.73 / $95.95
| Facility | | $25.33 | $53.73 | $95.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.09 / $18.09 / $18.09
| Professional | | $18.09 | $18.09 | $18.09 |
- 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
- $14.04 / $14.57 / $107.77
| Professional | | $14.04 | $14.57 | $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
- $8.25 / $11.43 / $55.80
| Professional | | $8.25 | $11.43 | $55.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.19 / $143.19 / $143.19
| Facility | | $143.19 | $143.19 | $143.19 |
- 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
- $10.75 / $17.28 / $39.69
| Professional | | $10.75 | $17.28 | $39.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.25 / $17.21 / $33.63
| Professional | | $8.25 | $17.21 | $33.63 |