- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.02 / $3.02 / $3.02
| Facility | | $3.02 | $3.02 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $5.01 / $17.78
| Professional | | $3.02 | $5.01 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.41 / $9.12 / $79.43
| Facility | | $7.41 | $9.12 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $6.61 / $12.59
| Professional | | $3.47 | $6.61 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.75 / $5.75 / $17.38
| Facility | | $5.75 | $5.75 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $5.89 / $5.89
| Professional | | $5.62 | $5.89 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.90 / $5.37 / $6.03
| Facility | | $4.90 | $5.37 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.57 / $4.57 / $6.03
| Professional | | $4.57 | $4.57 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $7.76 / $12.02
| Professional | | $7.76 | $7.76 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $371.54
| Facility | | $371.54 | $371.54 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.17 / $4.17 / $4.17
| Professional | | $4.17 | $4.17 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.41 / $9.12 / $79.43
| Facility | | $7.41 | $9.12 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $6.92 / $13.80
| Professional | | $3.47 | $6.92 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $5.75 / $6.03
| Professional | | $5.75 | $5.75 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.88 / $3.47 / $5.13
| Facility | | $2.88 | $3.47 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $5.13 / $8.51
| Professional | | $3.47 | $5.13 | $8.51 |