- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.27 / $16.27 / $20.34
| Facility | | $16.27 | $16.27 | $20.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.93 / $20.34 / $77.00
| Professional | | $15.93 | $20.34 | $77.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $967.00 / $57,255.43 / $79,506.39
| Facility | | $967.00 | $57,255.43 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.18 / $33.18 / $33.18
| Professional | | $33.18 | $33.18 | $33.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.88 / $38.88 / $38.88
| Facility | | $38.88 | $38.88 | $38.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.54 / $13.54 / $13.54
| Professional | | $13.54 | $13.54 | $13.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.84 / $44.93 / $48.11
| Professional | | $34.84 | $44.93 | $48.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.48 / $246.48 / $246.48
| Facility | | $246.48 | $246.48 | $246.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.27 / $20.34 / $142.18
| Facility | | $16.27 | $20.34 | $142.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.93 / $22.42 / $77.00
| Professional | | $15.93 | $22.42 | $77.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.79 / $49.50 / $65.40
| Professional | | $40.79 | $49.50 | $65.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.88 / $38.88 / $38.88
| Facility | | $38.88 | $38.88 | $38.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.54 / $13.54 / $13.54
| Professional | | $13.54 | $13.54 | $13.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.45 / $31.58 / $31.58
| Facility | | $19.45 | $31.58 | $31.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.45 / $31.58 / $31.58
| Professional | | $19.45 | $31.58 | $31.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.06 / $16.55 / $28.74
| Professional | | $14.06 | $16.55 | $28.74 |