- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.05 / $7.05 / $59.68
| Facility | | $7.05 | $7.05 | $59.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.25 / $8.81 / $11.50
| Professional | | $6.25 | $8.81 | $11.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $967.00 / $57,255.43 / $79,506.39
| Facility | | $967.00 | $57,255.43 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.39 / $14.39 / $14.39
| Professional | | $14.39 | $14.39 | $14.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.86 / $16.86 / $16.86
| Facility | | $16.86 | $16.86 | $16.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.34 / $7.34 / $7.34
| Professional | | $7.34 | $7.34 | $7.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.11 / $19.48 / $20.87
| Professional | | $15.11 | $19.48 | $20.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.05 / $8.81 / $59.68
| Facility | | $7.05 | $8.81 | $59.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.71 / $8.81 / $13.60
| Professional | | $6.71 | $8.81 | $13.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.70 / $20.50 / $28.30
| Professional | | $10.70 | $20.50 | $28.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.86 / $16.86 / $16.86
| Facility | | $16.86 | $16.86 | $16.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.34 / $7.34 / $7.34
| Professional | | $7.34 | $7.34 | $7.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.28 / $10.80 / $13.69
| Facility | | $10.28 | $10.80 | $13.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.28 / $13.69 / $13.69
| Professional | | $10.28 | $13.69 | $13.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.80 / $7.18 / $11.96
| Professional | | $5.80 | $7.18 | $11.96 |