- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.20 / $3.20 / $5.08
| Facility | | $3.20 | $3.20 | $5.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $4.00 / $5.22
| Professional | | $2.27 | $4.00 | $5.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.53 / $6.53 / $6.53
| Professional | | $6.53 | $6.53 | $6.53 |
- 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
- $4.98 / $6.53 / $6.53
| Professional | | $4.98 | $6.53 | $6.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.93 / $3.93 / $4.16
| Facility | | $3.93 | $3.93 | $4.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.34 / $3.34 / $4.62
| Professional | | $3.34 | $3.34 | $4.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.01 / $6.53 / $12.41
| Professional | | $6.01 | $6.53 | $12.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.89 / $4.40 / $4.65
| Professional | | $3.89 | $4.40 | $4.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.20 / $3.20 / $5.08
| Facility | | $3.20 | $3.20 | $5.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.20 / $4.00 / $6.18
| Professional | | $3.20 | $4.00 | $6.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.10 / $9.30 / $12.90
| Professional | | $8.10 | $9.30 | $12.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.93 / $3.93 / $4.16
| Facility | | $3.93 | $3.93 | $4.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.34 / $3.34 / $7.50
| Professional | | $3.34 | $3.34 | $7.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.66 / $6.22 / $6.22
| Facility | | $4.66 | $6.22 | $6.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.66 / $6.22 / $6.22
| Professional | | $4.66 | $6.22 | $6.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.17 / $3.26 / $5.71
| Professional | | $2.17 | $3.26 | $5.71 |