- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.50 / $12.50 / $19.85
| Facility | | $12.50 | $12.50 | $19.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.86 / $15.63 / $20.51
| Professional | | $8.86 | $15.63 | $20.51 |
- 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
- $19.42 / $25.50 / $25.50
| Professional | | $19.42 | $25.50 | $25.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.42 / $15.42 / $30.06
| Facility | | $15.42 | $15.42 | $30.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.11 / $13.11 / $19.05
| Professional | | $13.11 | $13.11 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.23 / $20.05 / $33.40
| Professional | | $9.23 | $20.05 | $33.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.18 / $18.18 / $18.18
| Professional | | $18.18 | $18.18 | $18.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.50 / $12.50 / $19.85
| Facility | | $12.50 | $12.50 | $19.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.86 / $15.63 / $21.80
| Professional | | $8.86 | $15.63 | $21.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.10 / $34.79 / $50.20
| Professional | | $19.10 | $34.79 | $50.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.42 / $15.42 / $30.06
| Facility | | $15.42 | $15.42 | $30.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.11 / $13.11 / $29.63
| Professional | | $13.11 | $13.11 | $29.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.23 / $24.27 / $24.27
| Facility | | $18.23 | $24.27 | $24.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.23 / $24.27 / $24.42
| Professional | | $18.23 | $24.27 | $24.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.01 / $12.78 / $23.00
| Professional | | $9.01 | $12.78 | $23.00 |