- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.39 / $8.39 / $13.32
| Facility | | $8.39 | $8.39 | $13.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.45 / $10.49 / $13.68
| Professional | | $7.45 | $10.49 | $13.68 |
- 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
- $17.11 / $17.11 / $17.11
| Professional | | $17.11 | $17.11 | $17.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.05 / $20.05 / $20.05
| Facility | | $20.05 | $20.05 | $20.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.75 / $8.75 / $8.75
| Professional | | $8.75 | $8.75 | $8.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.97 / $23.17 / $24.81
| Professional | | $17.97 | $23.17 | $24.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.39 / $8.39 / $13.32
| Facility | | $8.39 | $8.39 | $13.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.98 / $10.49 / $16.19
| Professional | | $7.98 | $10.49 | $16.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.70 / $24.40 / $33.70
| Professional | | $12.70 | $24.40 | $33.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.05 / $20.05 / $20.05
| Facility | | $20.05 | $20.05 | $20.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.75 / $8.75 / $8.75
| Professional | | $8.75 | $8.75 | $8.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.23 / $12.85 / $16.29
| Facility | | $12.23 | $12.85 | $16.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.23 / $16.29 / $16.29
| Professional | | $12.23 | $16.29 | $16.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.71 / $8.57 / $18.82
| Professional | | $6.71 | $8.57 | $18.82 |