- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.04 / $99.76
| Facility | | $0.02 | $0.04 | $99.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.00 / $129.00 / $129.00
| Professional | | $129.00 | $129.00 | $129.00 |
- 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 / $38.54
| Professional | | $11.52 | $17.28 | $38.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.29 / $52.96 / $95.95
| Facility | | $21.29 | $52.96 | $95.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.95 / $14.95 / $14.95
| Professional | | $14.95 | $14.95 | $14.95 |
- 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 / $23.95 / $107.77
| Professional | | $14.57 | $23.95 | $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
- $21.53 / $29.84 / $72.03
| Professional | | $21.53 | $29.84 | $72.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.65 / $29.61 / $35.34
| Facility | | $26.65 | $29.61 | $35.34 |
- 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 / $38.54
| Professional | | $10.77 | $17.28 | $38.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.24 / $17.28 / $37.56
| Professional | | $9.24 | $17.28 | $37.56 |