- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.61 / $97.35 / $244.02
| Facility | | $12.61 | $97.35 | $244.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.50 / $17.91 / $59.00
| Professional | | $14.50 | $17.91 | $59.00 |
- 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
- $25.72 / $25.72 / $25.72
| Professional | | $25.72 | $25.72 | $25.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.14 / $30.14 / $30.14
| Facility | | $30.14 | $30.14 | $30.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.49 / $10.49 / $10.49
| Professional | | $10.49 | $10.49 | $10.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.01 / $34.82 / $37.29
| Professional | | $27.01 | $34.82 | $37.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.11 / $104.34 / $216.02
| Facility | | $94.11 | $104.34 | $216.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.61 / $97.35 / $244.02
| Facility | | $12.61 | $97.35 | $244.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.76 / $19.57 / $59.00
| Professional | | $15.76 | $19.57 | $59.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.60 / $38.40 / $50.70
| Professional | | $31.60 | $38.40 | $50.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.14 / $30.14 / $30.14
| Facility | | $30.14 | $30.14 | $30.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.49 / $10.49 / $10.49
| Professional | | $10.49 | $10.49 | $10.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.08 / $24.48 / $24.48
| Facility | | $15.08 | $24.48 | $24.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.08 / $24.48 / $24.48
| Professional | | $15.08 | $24.48 | $24.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.56 / $12.83 / $21.39
| Professional | | $8.56 | $12.83 | $21.39 |