- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.00 / $3.02 / $26.92
| Facility | | $2.00 | $3.02 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.02 / $3.98
| Professional | | $3.02 | $3.02 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $15.49 / $29.51
| Professional | | $3.47 | $15.49 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $20.89 / $20.89
| Facility | | $20.89 | $20.89 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.89 / $20.89 / $20.89
| Professional | | $20.89 | $20.89 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $39.81 / $50,118.72
| Facility | | $39.81 | $39.81 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $6.76 / $25.12
| Professional | | $6.76 | $6.76 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.99 / $39.81 / $93.33
| Facility | | $23.99 | $39.81 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $34.67 / $47.86
| Professional | | $22.91 | $34.67 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $16.60 / $16.60
| Facility | | $16.60 | $16.60 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $17.78 / $17.78
| Professional | | $16.60 | $17.78 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.85 / $22.91 / $22.91
| Professional | | $15.85 | $22.91 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $13.49 / $22.91
| Professional | | $8.32 | $13.49 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $16.60 / $16.60
| Facility | | $16.60 | $16.60 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $16.60 / $17.78
| Professional | | $16.60 | $16.60 | $17.78 |