- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $13.18 / $26.30
| Facility | | $10.00 | $13.18 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $8.91 / $12.02
| Professional | | $8.91 | $8.91 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $10.47
| Facility | | $10.00 | $10.00 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $8.13 / $8.71
| Facility | | $8.13 | $8.13 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.13 / $8.13 / $8.13
| Professional | | $8.13 | $8.13 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.32 / $9.33 / $85.11
| Facility | | $8.32 | $9.33 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $41.69
| Professional | | $10.00 | $10.00 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.33 / $12.30 / $33.88
| Facility | | $9.33 | $12.30 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $10.72 / $15.14
| Professional | | $10.72 | $10.72 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $9.77 / $10.23
| Facility | | $9.77 | $9.77 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $9.77 / $10.23
| Professional | | $9.77 | $9.77 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $50,118.72 / $75,857.76
| Facility | | $12.59 | $50,118.72 | $75,857.76 |
- 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
- $9.55 / $10.00 / $14.45
| Professional | | $9.55 | $10.00 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.77 / $9.77 / $11.48
| Facility | | $9.77 | $9.77 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $10.23 / $11.75
| Professional | | $9.77 | $10.23 | $11.75 |