- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.07 / $21.07 / $33.44
| Facility | | $21.07 | $21.07 | $33.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.94 / $26.33 / $34.35
| Professional | | $14.94 | $26.33 | $34.35 |
- 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
- $32.71 / $42.96 / $42.96
| Professional | | $32.71 | $42.96 | $42.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.81 / $25.81 / $50.34
| Facility | | $25.81 | $25.81 | $50.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.94 / $21.94 / $31.88
| Professional | | $21.94 | $21.94 | $31.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.52 / $42.96 / $81.62
| Professional | | $39.52 | $42.96 | $81.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.07 / $21.07 / $33.44
| Facility | | $21.07 | $21.07 | $33.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.94 / $26.33 / $37.61
| Professional | | $14.94 | $26.33 | $37.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.30 / $61.30 / $84.60
| Professional | | $53.30 | $61.30 | $84.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.81 / $25.81 / $50.34
| Facility | | $25.81 | $25.81 | $50.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.94 / $21.94 / $49.88
| Professional | | $21.94 | $21.94 | $49.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.72 / $40.89 / $40.89
| Facility | | $30.72 | $40.89 | $40.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.72 / $40.89 / $40.89
| Professional | | $30.72 | $40.89 | $40.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.08 / $21.43 / $38.75
| Professional | | $15.08 | $21.43 | $38.75 |