- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.39 / $7.39 / $11.73
| Facility | | $7.39 | $7.39 | $11.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.24 / $9.19 / $9.96
| Professional | | $5.24 | $9.19 | $9.96 |
- 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
- $11.48 / $15.07 / $15.07
| Professional | | $11.48 | $15.07 | $15.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.05 / $9.05 / $17.66
| Facility | | $9.05 | $9.05 | $17.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.69 / $7.69 / $11.18
| Professional | | $7.69 | $7.69 | $11.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.79 / $12.81 / $24.34
| Professional | | $11.79 | $12.81 | $24.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.39 / $7.39 / $11.73
| Facility | | $7.39 | $7.39 | $11.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.24 / $9.24 / $11.73
| Professional | | $5.24 | $9.24 | $11.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.20 / $20.60 / $29.70
| Professional | | $11.20 | $20.60 | $29.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.05 / $9.05 / $17.66
| Facility | | $9.05 | $9.05 | $17.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.69 / $7.69 / $17.63
| Professional | | $7.69 | $7.69 | $17.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.78 / $14.35 / $14.35
| Facility | | $10.78 | $14.35 | $14.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.78 / $14.35 / $14.35
| Professional | | $10.78 | $14.35 | $14.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.29 / $7.52 / $13.17
| Professional | | $5.29 | $7.52 | $13.17 |