- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.01 / $8.01 / $12.73
| Facility | | $8.01 | $8.01 | $12.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.32 / $10.02 / $12.73
| Professional | | $6.32 | $10.02 | $12.73 |
- 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
- $16.32 / $16.32 / $16.32
| Professional | | $16.32 | $16.32 | $16.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.32 / $19.32 / $19.32
| Facility | | $19.32 | $19.32 | $19.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.42 / $8.42 / $8.42
| Professional | | $8.42 | $8.42 | $8.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.73 / $19.00 / $21.39
| Professional | | $14.73 | $19.00 | $21.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.01 / $8.01 / $12.73
| Facility | | $8.01 | $8.01 | $12.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.10 / $10.02 / $13.66
| Professional | | $7.10 | $10.02 | $13.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.80 / $20.30 / $32.20
| Professional | | $5.80 | $20.30 | $32.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.32 / $19.32 / $19.32
| Facility | | $19.32 | $19.32 | $19.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.42 / $8.42 / $8.42
| Professional | | $8.42 | $8.42 | $8.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.31 / $15.55 / $15.55
| Facility | | $12.31 | $15.55 | $15.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.31 / $15.55 / $15.70
| Professional | | $12.31 | $15.55 | $15.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.38 / $8.21 / $16.97
| Professional | | $6.38 | $8.21 | $16.97 |