- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $24.55 / $64.57
| Facility | | $9.77 | $24.55 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $8.91 / $10.96
| Professional | | $8.91 | $8.91 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $11.75 / $22.91
| Facility | | $10.47 | $11.75 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $10.00 / $18.62
| Professional | | $7.59 | $10.00 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $11.22 / $14.13
| Facility | | $10.00 | $11.22 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $12.02 / $24.55
| Professional | | $9.77 | $12.02 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $10.00
| Facility | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $398.11
| Professional | | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $3.55 / $3.55
| Professional | | $3.55 | $3.55 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $13.80 / $26.92
| Facility | | $3.31 | $13.80 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $10.72 / $10.72
| Professional | | $9.77 | $10.72 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $7.08 / $7.08
| Professional | | $7.08 | $7.08 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.48 / $14.79 / $19.50
| Professional | | $11.48 | $14.79 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.48 / $11.48 / $11.48
| Facility | | $11.48 | $11.48 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $10.47 / $22.39
| Professional | | $9.77 | $10.47 | $22.39 |