- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.30 / $8.30 / $32.11
| Facility | | $8.30 | $8.30 | $32.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.90 / $9.22 / $11.11
| Professional | | $7.90 | $9.22 | $11.11 |
- 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
- $15.37 / $20.18 / $20.18
| Professional | | $15.37 | $20.18 | $20.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.40 / $13.40 / $20.18
| Facility | | $13.40 | $13.40 | $20.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $9.77 / $17.67
| Professional | | $9.77 | $9.77 | $17.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.57 / $20.18 / $38.34
| Professional | | $18.57 | $20.18 | $38.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.30 / $8.30 / $32.11
| Facility | | $8.30 | $8.30 | $32.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.90 / $9.53 / $13.01
| Professional | | $7.90 | $9.53 | $13.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.00 / $28.80 / $39.79
| Professional | | $25.00 | $28.80 | $39.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.40 / $13.40 / $20.18
| Facility | | $13.40 | $13.40 | $20.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $9.77 / $24.00
| Professional | | $9.77 | $9.77 | $24.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.42 / $19.21 / $19.21
| Facility | | $14.42 | $19.21 | $19.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.42 / $19.21 / $19.69
| Professional | | $14.42 | $19.21 | $19.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.10 / $9.11 / $13.85
| Facility | | $7.10 | $9.11 | $13.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.62 / $10.17 / $17.63
| Professional | | $7.62 | $10.17 | $17.63 |