- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.58 / $6.58 / $10.45
| Facility | | $6.58 | $6.58 | $10.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.77 / $8.23 / $10.73
| Professional | | $5.77 | $8.23 | $10.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.41 / $13.41 / $13.41
| Professional | | $13.41 | $13.41 | $13.41 |
- 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 / $13.41 / $13.41
| Professional | | $10.22 | $13.41 | $13.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.07 / $8.07 / $8.53
| Facility | | $8.07 | $8.07 | $8.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.86 / $6.86 / $9.49
| Professional | | $6.86 | $6.86 | $9.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.34 / $13.41 / $25.48
| Professional | | $12.34 | $13.41 | $25.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.69 / $9.39 / $10.06
| Professional | | $8.69 | $9.39 | $10.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.58 / $6.58 / $10.45
| Facility | | $6.58 | $6.58 | $10.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.58 / $8.23 / $11.75
| Professional | | $6.58 | $8.23 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $19.10 / $26.40
| Professional | | $16.60 | $19.10 | $26.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.07 / $8.07 / $8.53
| Facility | | $8.07 | $8.07 | $8.53 |
- 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
- $9.60 / $12.77 / $12.77
| Facility | | $9.60 | $12.77 | $12.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.60 / $12.77 / $12.77
| Professional | | $9.60 | $12.77 | $12.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.46 / $6.70 / $11.73
| Professional | | $4.46 | $6.70 | $11.73 |