- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.75 / $14.75 / $57.08
| Facility | | $14.75 | $14.75 | $57.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.67 / $16.87 / $24.47
| Professional | | $14.67 | $16.87 | $24.47 |
- 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
- $27.30 / $35.85 / $35.85
| Professional | | $27.30 | $35.85 | $35.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.10 / $23.10 / $42.05
| Facility | | $23.10 | $23.10 | $42.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.86 / $16.86 / $36.82
| Professional | | $16.86 | $16.86 | $36.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.69 / $42.05 / $79.90
| Professional | | $38.69 | $42.05 | $79.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.21 / $24.21 / $26.89
| Professional | | $24.21 | $24.21 | $26.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.75 / $14.75 / $57.08
| Facility | | $14.75 | $14.75 | $57.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.67 / $16.95 / $56.02
| Professional | | $14.67 | $16.95 | $56.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.10 / $19.80 / $82.80
| Professional | | $15.10 | $19.80 | $82.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.10 / $23.10 / $42.05
| Facility | | $23.10 | $23.10 | $42.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.86 / $16.86 / $41.25
| Professional | | $16.86 | $16.86 | $41.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.63 / $34.11 / $34.11
| Facility | | $25.63 | $34.11 | $34.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.63 / $34.11 / $40.02
| Professional | | $25.63 | $34.11 | $40.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.85 / $18.32 / $32.33
| Professional | | $14.85 | $18.32 | $32.33 |