- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.15 / $7.15 / $11.35
| Facility | | $7.15 | $7.15 | $11.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.21 / $8.94 / $11.07
| Professional | | $6.21 | $8.94 | $11.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $967.00 / $57,255.43 / $79,506.39
| Facility | | $967.00 | $57,255.43 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.58 / $14.58 / $14.58
| Professional | | $14.58 | $14.58 | $14.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.94 / $16.94 / $16.94
| Facility | | $16.94 | $16.94 | $16.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.70 / $5.95 / $5.95
| Professional | | $5.70 | $5.95 | $5.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.31 / $19.73 / $21.14
| Professional | | $15.31 | $19.73 | $21.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.15 / $7.15 / $11.35
| Facility | | $7.15 | $7.15 | $11.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.35 / $8.94 / $11.35
| Professional | | $6.35 | $8.94 | $11.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.80 / $20.80 / $28.70
| Professional | | $10.80 | $20.80 | $28.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.94 / $16.94 / $16.94
| Facility | | $16.94 | $16.94 | $16.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.70 / $5.95 / $5.95
| Professional | | $5.70 | $5.95 | $5.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.43 / $13.88 / $13.88
| Facility | | $10.43 | $13.88 | $13.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.43 / $13.88 / $13.88
| Professional | | $10.43 | $13.88 | $13.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.84 / $7.28 / $13.16
| Professional | | $4.84 | $7.28 | $13.16 |