- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.61 / $11.31 / $739.20
| Facility | | $8.61 | $11.31 | $739.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.13 / $10.78 / $16.55
| Professional | | $6.13 | $10.78 | $16.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.40 / $17.60 / $17.60
| Professional | | $13.40 | $17.60 | $17.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.44 / $12.44 / $24.25
| Facility | | $12.44 | $12.44 | $24.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.57 / $10.57 / $16.09
| Professional | | $10.57 | $10.57 | $16.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.39 / $18.91 / $35.93
| Professional | | $17.39 | $18.91 | $35.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.61 / $13.69 / $739.20
| Facility | | $8.61 | $13.69 | $739.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.66 / $10.78 / $17.88
| Professional | | $5.66 | $10.78 | $17.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.10 / $24.00 / $34.60
| Professional | | $13.10 | $24.00 | $34.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.44 / $12.44 / $24.25
| Facility | | $12.44 | $12.44 | $24.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.57 / $10.57 / $24.00
| Professional | | $10.57 | $10.57 | $24.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $16.75 / $16.75
| Facility | | $12.59 | $16.75 | $16.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $16.75 / $19.70
| Professional | | $12.59 | $16.75 | $19.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.09 / $8.77 / $15.71
| Professional | | $6.09 | $8.77 | $15.71 |