- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.57 / $6.97 / $39.97
| Facility | | $5.57 | $6.97 | $39.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.57 / $7.22 / $25.00
| Professional | | $5.57 | $7.22 | $25.00 |
- 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
- $11.37 / $11.37 / $11.37
| Professional | | $11.37 | $11.37 | $11.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.32 / $13.32 / $13.32
| Facility | | $13.32 | $13.32 | $13.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.63 / $4.63 / $4.63
| Professional | | $4.63 | $4.63 | $4.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.94 / $15.39 / $16.48
| Professional | | $11.94 | $15.39 | $16.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.79 / $36.79 / $36.79
| Facility | | $36.79 | $36.79 | $36.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.57 / $6.97 / $39.97
| Facility | | $5.57 | $6.97 | $39.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.38 / $7.68 / $26.00
| Professional | | $6.38 | $7.68 | $26.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.00 / $17.00 / $22.40
| Professional | | $14.00 | $17.00 | $22.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.32 / $13.32 / $13.32
| Facility | | $13.32 | $13.32 | $13.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.63 / $4.63 / $4.63
| Professional | | $4.63 | $4.63 | $4.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.66 / $10.82 / $10.82
| Facility | | $6.66 | $10.82 | $10.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.66 / $10.82 / $10.82
| Professional | | $6.66 | $10.82 | $10.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.82 / $5.67 / $9.44
| Professional | | $4.82 | $5.67 | $9.44 |