- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.55 / $7.55 / $29.22
| Facility | | $7.55 | $7.55 | $29.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.18 / $8.67 / $11.43
| Professional | | $7.18 | $8.67 | $11.43 |
- 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
- $13.97 / $18.35 / $18.35
| Professional | | $13.97 | $18.35 | $18.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.18 / $12.18 / $18.35
| Facility | | $12.18 | $12.18 | $18.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.89 / $8.89 / $16.05
| Professional | | $8.89 | $8.89 | $16.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.88 / $18.35 / $34.86
| Professional | | $16.88 | $18.35 | $34.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.55 / $7.55 / $29.22
| Facility | | $7.55 | $7.55 | $29.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.18 / $8.83 / $13.77
| Professional | | $7.18 | $8.83 | $13.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.40 / $25.00 / $36.10
| Professional | | $12.40 | $25.00 | $36.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.18 / $12.18 / $18.35
| Facility | | $12.18 | $12.18 | $18.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.89 / $8.89 / $21.75
| Professional | | $8.89 | $8.89 | $21.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.11 / $17.46 / $17.46
| Facility | | $13.11 | $17.46 | $17.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.11 / $17.46 / $17.94
| Professional | | $13.11 | $17.46 | $17.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.58 / $9.15 / $16.02
| Professional | | $7.58 | $9.15 | $16.02 |