- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $15.14 / $26.92
| Facility | | $10.96 | $15.14 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $12.02 / $26.92
| Professional | | $8.91 | $12.02 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $6.31 / $19.95
| Professional | | $5.25 | $6.31 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.59 / $13.49 / $13.49
| Facility | | $12.59 | $13.49 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $13.49 / $13.49
| Professional | | $13.49 | $13.49 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.70 / $25.70 / $50,118.72
| Facility | | $25.70 | $25.70 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $6.61 / $16.22
| Professional | | $6.61 | $6.61 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.60 / $27.54 / $63.10
| Facility | | $16.60 | $27.54 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $23.99 / $33.11
| Professional | | $16.60 | $23.99 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $20.89 / $20.89
| Facility | | $20.89 | $20.89 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.89 / $22.39 / $22.39
| Professional | | $20.89 | $22.39 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $15.85 / $15.85
| Professional | | $10.72 | $15.85 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.37 / $8.13 / $14.79
| Professional | | $5.37 | $8.13 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.89 / $20.89 / $20.89
| Facility | | $20.89 | $20.89 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.89 / $20.89 / $22.39
| Professional | | $20.89 | $20.89 | $22.39 |