- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.58 / $2.58 / $4.09
| Facility | | $2.58 | $2.58 | $4.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.83 / $3.22 / $4.20
| Professional | | $1.83 | $3.22 | $4.20 |
- 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
- $4.00 / $5.25 / $5.25
| Professional | | $4.00 | $5.25 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.51 / $3.51 / $6.16
| Facility | | $3.51 | $3.51 | $6.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.98 / $2.98 / $3.90
| Professional | | $2.98 | $2.98 | $3.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.21 / $4.83 / $7.11
| Professional | | $3.21 | $4.83 | $7.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.58 / $2.58 / $4.09
| Facility | | $2.58 | $2.58 | $4.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.22 / $3.22 / $4.97
| Professional | | $2.22 | $3.22 | $4.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $7.50 / $10.30
| Professional | | $6.50 | $7.50 | $10.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.51 / $3.51 / $6.16
| Facility | | $3.51 | $3.51 | $6.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.98 / $2.98 / $6.00
| Professional | | $2.98 | $2.98 | $6.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.76 / $5.00 / $5.00
| Facility | | $3.76 | $5.00 | $5.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.76 / $5.00 / $5.00
| Professional | | $3.76 | $5.00 | $5.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.79 / $2.62 / $4.74
| Professional | | $1.79 | $2.62 | $4.74 |