- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.92 / $20.92 / $80.95
| Facility | | $20.92 | $20.92 | $80.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.89 / $24.04 / $30.74
| Professional | | $19.89 | $24.04 | $30.74 |
- 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
- $38.71 / $50.84 / $50.84
| Professional | | $38.71 | $50.84 | $50.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.89 / $34.89 / $50.84
| Facility | | $34.89 | $34.89 | $50.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.47 / $25.47 / $44.52
| Professional | | $25.47 | $25.47 | $44.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $50.84 / $96.60
| Professional | | $46.77 | $50.84 | $96.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.96 / $38.96 / $38.96
| Professional | | $38.96 | $38.96 | $38.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.92 / $20.92 / $80.95
| Facility | | $20.92 | $20.92 | $80.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.89 / $24.49 / $45.84
| Professional | | $19.89 | $24.49 | $45.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.60 / $14.00 / $100.20
| Professional | | $10.60 | $14.00 | $100.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.89 / $34.89 / $50.84
| Facility | | $34.89 | $34.89 | $50.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.47 / $25.47 / $60.38
| Professional | | $25.47 | $25.47 | $60.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.35 / $48.39 / $48.39
| Facility | | $36.35 | $48.39 | $48.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.35 / $48.39 / $49.61
| Professional | | $36.35 | $48.39 | $49.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.46 / $25.62 / $45.85
| Professional | | $19.46 | $25.62 | $45.85 |