- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.44 / $8.44 / $13.41
| Facility | | $8.44 | $8.44 | $13.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.49 / $10.56 / $13.77
| Professional | | $7.49 | $10.56 | $13.77 |
- 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
- $17.22 / $17.22 / $17.22
| Professional | | $17.22 | $17.22 | $17.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.18 / $20.18 / $20.18
| Facility | | $20.18 | $20.18 | $20.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.78 / $8.78 / $8.78
| Professional | | $8.78 | $8.78 | $8.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.07 / $23.32 / $24.97
| Professional | | $18.07 | $23.32 | $24.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.44 / $8.44 / $13.41
| Facility | | $8.44 | $8.44 | $13.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.02 / $10.56 / $16.29
| Professional | | $8.02 | $10.56 | $16.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.80 / $24.50 / $33.90
| Professional | | $12.80 | $24.50 | $33.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.18 / $20.18 / $20.18
| Facility | | $20.18 | $20.18 | $20.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.78 / $8.78 / $8.78
| Professional | | $8.78 | $8.78 | $8.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.30 / $12.93 / $16.39
| Facility | | $12.30 | $12.93 | $16.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $16.39 / $16.39
| Professional | | $12.30 | $16.39 | $16.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.73 / $8.59 / $15.52
| Professional | | $5.73 | $8.59 | $15.52 |