- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.77 / $17.77 / $28.21
| Facility | | $17.77 | $17.77 | $28.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.26 / $17.77 / $31.73
| Professional | | $11.26 | $17.77 | $31.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.04 / $34.04 / $36.24
| Professional | | $34.04 | $34.04 | $36.24 |
- 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
- $27.59 / $36.24 / $36.24
| Professional | | $27.59 | $36.24 | $36.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.26 / $24.26 / $24.26
| Facility | | $24.26 | $24.26 | $24.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.71 / $17.71 / $29.26
| Professional | | $17.71 | $17.71 | $29.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.34 / $36.24 / $68.86
| Professional | | $33.34 | $36.24 | $68.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.92 / $24.92 / $25.37
| Professional | | $24.92 | $24.92 | $25.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.77 / $17.77 / $28.21
| Facility | | $17.77 | $17.77 | $28.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.26 / $22.21 / $34.27
| Professional | | $11.26 | $22.21 | $34.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.10 / $15.90 / $71.40
| Professional | | $12.10 | $15.90 | $71.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.26 / $24.26 / $24.26
| Facility | | $24.26 | $24.26 | $24.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.71 / $17.71 / $42.00
| Professional | | $17.71 | $17.71 | $42.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.20 / $34.49 / $34.49
| Facility | | $23.20 | $34.49 | $34.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.20 / $34.49 / $34.49
| Professional | | $23.20 | $34.49 | $34.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.94 / $19.57 / $31.66
| Professional | | $15.94 | $19.57 | $31.66 |