- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.62 / $15.62 / $24.79
| Facility | | $15.62 | $15.62 | $24.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.86 / $19.52 / $25.47
| Professional | | $13.86 | $19.52 | $25.47 |
- 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
- $31.86 / $31.86 / $31.86
| Professional | | $31.86 | $31.86 | $31.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.33 / $37.33 / $37.33
| Facility | | $37.33 | $37.33 | $37.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.27 / $16.27 / $16.27
| Professional | | $16.27 | $16.27 | $16.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.45 / $43.14 / $46.20
| Professional | | $33.45 | $43.14 | $46.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.62 / $15.62 / $24.79
| Facility | | $15.62 | $15.62 | $24.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.86 / $19.52 / $30.12
| Professional | | $14.86 | $19.52 | $30.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.80 / $45.40 / $62.80
| Professional | | $23.80 | $45.40 | $62.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.33 / $37.33 / $37.33
| Facility | | $37.33 | $37.33 | $37.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.27 / $16.27 / $16.27
| Professional | | $16.27 | $16.27 | $16.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.77 / $23.93 / $30.32
| Facility | | $22.77 | $23.93 | $30.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.77 / $30.32 / $30.32
| Professional | | $22.77 | $30.32 | $30.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.85 / $16.05 / $28.72
| Professional | | $12.85 | $16.05 | $28.72 |