- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.59 / $6.59 / $10.45
| Facility | | $6.59 | $6.59 | $10.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.67 / $8.23 / $10.74
| Professional | | $4.67 | $8.23 | $10.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.22 / $13.42 / $13.42
| Professional | | $10.22 | $13.42 | $13.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.07 / $8.07 / $15.73
| Facility | | $8.07 | $8.07 | $15.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.86 / $6.86 / $9.96
| Professional | | $6.86 | $6.86 | $9.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.35 / $13.42 / $25.50
| Professional | | $12.35 | $13.42 | $25.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.59 / $6.59 / $10.45
| Facility | | $6.59 | $6.59 | $10.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.68 / $8.23 / $12.70
| Professional | | $5.68 | $8.23 | $12.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.70 / $19.20 / $26.50
| Professional | | $16.70 | $19.20 | $26.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.07 / $8.07 / $15.73
| Facility | | $8.07 | $8.07 | $15.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.86 / $6.86 / $15.38
| Professional | | $6.86 | $6.86 | $15.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.61 / $12.78 / $12.78
| Facility | | $9.61 | $12.78 | $12.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.61 / $12.78 / $12.78
| Professional | | $9.61 | $12.78 | $12.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.51 / $5.65 / $8.58
| Facility | | $4.51 | $5.65 | $8.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.58 / $6.70 / $11.17
| Professional | | $4.58 | $6.70 | $11.17 |