- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.23 / $10.23 / $11.09
| Facility | | $10.23 | $10.23 | $11.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.55 / $12.97 / $16.26
| Professional | | $10.55 | $12.97 | $16.26 |
- 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
- $20.51 / $26.94 / $26.94
| Professional | | $20.51 | $26.94 | $26.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.45 / $18.45 / $26.94
| Facility | | $18.45 | $18.45 | $26.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.47 / $13.47 / $23.59
| Professional | | $13.47 | $13.47 | $23.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.78 / $26.94 / $51.19
| Professional | | $24.78 | $26.94 | $51.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.00 / $22.00 / $101.68
| Facility | | $22.00 | $22.00 | $101.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $18.20 / $20.21
| Professional | | $18.20 | $18.20 | $20.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.23 / $10.23 / $42.92
| Facility | | $10.23 | $10.23 | $42.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.55 / $13.92 / $16.98
| Professional | | $10.55 | $13.92 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.00 / $38.40 / $53.10
| Professional | | $28.00 | $38.40 | $53.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.45 / $18.45 / $26.94
| Facility | | $18.45 | $18.45 | $26.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.47 / $13.47 / $31.88
| Professional | | $13.47 | $13.47 | $31.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.26 / $25.64 / $25.64
| Facility | | $19.26 | $25.64 | $25.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.26 / $25.64 / $26.23
| Professional | | $19.26 | $25.64 | $26.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.26 / $13.45 / $24.29
| Professional | | $9.26 | $13.45 | $24.29 |