- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $8.13 / $10.16
| Facility | | $8.13 | $8.13 | $10.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.96 / $10.16 / $21.23
| Professional | | $7.96 | $10.16 | $21.23 |
- 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
- $16.57 / $16.57 / $16.57
| Professional | | $16.57 | $16.57 | $16.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.43 / $19.43 / $19.43
| Facility | | $19.43 | $19.43 | $19.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $6.76 / $6.76
| Professional | | $6.76 | $6.76 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.41 / $22.45 / $24.04
| Professional | | $17.41 | $22.45 | $24.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $8.13 / $10.16
| Facility | | $8.13 | $8.13 | $10.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.96 / $10.16 / $21.23
| Professional | | $7.96 | $10.16 | $21.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.39 / $24.70 / $32.70
| Professional | | $20.39 | $24.70 | $32.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.43 / $19.43 / $19.43
| Facility | | $19.43 | $19.43 | $19.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $6.76 / $6.76
| Professional | | $6.76 | $6.76 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.72 / $15.78 / $15.78
| Facility | | $9.72 | $15.78 | $15.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.72 / $15.78 / $15.78
| Professional | | $9.72 | $15.78 | $15.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.48 / $8.27 / $13.79
| Professional | | $6.48 | $8.27 | $13.79 |