- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.09 / $11.09 / $42.92
| Facility | | $11.09 | $11.09 | $42.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.55 / $12.27 / $15.59
| Professional | | $10.55 | $12.27 | $15.59 |
- 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
- $15.39 / $15.39 / $26.94
| Facility | | $15.39 | $15.39 | $26.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.23 / $11.23 / $31.88
| Professional | | $11.23 | $11.23 | $31.88 |
- 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
- $11.09 / $11.09 / $42.92
| Facility | | $11.09 | $11.09 | $42.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.55 / $12.74 / $24.26
| Professional | | $10.55 | $12.74 | $24.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.40 / $38.40 / $53.10
| Professional | | $33.40 | $38.40 | $53.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.39 / $15.39 / $26.94
| Facility | | $15.39 | $15.39 | $26.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.23 / $11.23 / $32.19
| Professional | | $11.23 | $11.23 | $32.19 |
- 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
- Facility
- Modifier
- Low / Median / High Price
- $9.47 / $12.18 / $14.22
| Facility | | $9.47 | $12.18 | $14.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $13.45 / $22.41
| Professional | | $10.30 | $13.45 | $22.41 |