- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.29 / $10.29 / $16.32
| Facility | | $10.29 | $10.29 | $16.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.30 / $12.86 / $16.77
| Professional | | $7.30 | $12.86 | $16.77 |
- 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
- $15.98 / $20.98 / $20.98
| Professional | | $15.98 | $20.98 | $20.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.91 / $13.91 / $24.59
| Facility | | $13.91 | $13.91 | $24.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.56 / $11.82 / $14.33
| Professional | | $8.56 | $11.82 | $14.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.30 / $20.98 / $39.86
| Professional | | $19.30 | $20.98 | $39.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.29 / $10.29 / $16.32
| Facility | | $10.29 | $10.29 | $16.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.86 / $12.86 / $19.84
| Professional | | $8.86 | $12.86 | $19.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.00 / $29.90 / $41.30
| Professional | | $26.00 | $29.90 | $41.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.91 / $13.91 / $24.59
| Facility | | $13.91 | $13.91 | $24.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.56 / $11.82 / $14.83
| Professional | | $8.56 | $11.82 | $14.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.00 / $19.97 / $19.97
| Facility | | $15.00 | $19.97 | $19.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.00 / $19.97 / $19.97
| Professional | | $15.00 | $19.97 | $19.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.15 / $10.47 / $18.34
| Professional | | $7.15 | $10.47 | $18.34 |