- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.34 / $2.34 / $3.72
| Facility | | $2.34 | $2.34 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.66 / $2.93 / $3.81
| Professional | | $1.66 | $2.93 | $3.81 |
- 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
- $3.63 / $4.76 / $4.76
| Professional | | $3.63 | $4.76 | $4.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.86 / $2.86 / $5.59
| Facility | | $2.86 | $2.86 | $5.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.43 / $2.43 / $3.37
| Professional | | $2.43 | $2.43 | $3.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.43 / $4.38 / $6.46
| Professional | | $2.43 | $4.38 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.84 / $3.22 / $3.58
| Professional | | $2.84 | $3.22 | $3.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.34 / $2.34 / $3.72
| Facility | | $2.34 | $2.34 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.30 / $2.88 / $4.76
| Professional | | $1.30 | $2.88 | $4.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.90 / $6.80 / $9.40
| Professional | | $5.90 | $6.80 | $9.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.86 / $2.86 / $5.59
| Facility | | $2.86 | $2.86 | $5.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.43 / $2.43 / $5.63
| Professional | | $2.43 | $2.43 | $5.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.40 / $4.54 / $4.54
| Facility | | $3.40 | $4.54 | $4.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.40 / $4.54 / $4.54
| Professional | | $3.40 | $4.54 | $4.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.59 / $2.38 / $4.28
| Professional | | $1.59 | $2.38 | $4.28 |