- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.67 / $16.45 / $16.45
| Facility | | $15.67 | $16.45 | $16.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.89 / $15.67 / $20.52
| Professional | | $9.89 | $15.67 | $20.52 |
- 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
- $29.82 / $42.86 / $44.47
| Professional | | $29.82 | $42.86 | $44.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.96 / $18.96 / $39.31
| Facility | | $18.96 | $18.96 | $39.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.12 / $16.12 / $23.59
| Professional | | $16.12 | $16.12 | $23.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.62 / $62.62 / $62.62
| Facility | | $62.62 | $62.62 | $62.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.43 / $36.38 / $46.89
| Professional | | $27.43 | $36.38 | $46.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.45 / $16.45 / $16.45
| Facility | | $16.45 | $16.45 | $16.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.89 / $16.45 / $23.68
| Professional | | $9.89 | $16.45 | $23.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.20 / $44.80 / $58.70
| Professional | | $37.20 | $44.80 | $58.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.96 / $18.96 / $39.31
| Facility | | $18.96 | $18.96 | $39.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.12 / $16.12 / $34.50
| Professional | | $16.12 | $16.12 | $34.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.32 / $28.38 / $28.38
| Facility | | $21.32 | $28.38 | $28.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.32 / $28.38 / $28.38
| Professional | | $21.32 | $28.38 | $28.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.71 / $14.87 / $26.78
| Professional | | $10.71 | $14.87 | $26.78 |