- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.85 / $1.85 / $2.95
| Facility | | $1.85 | $1.85 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $2.20 / $2.95
| Professional | | $1.07 | $2.20 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $3.78 / $45.00
| Professional | | $2.27 | $3.78 | $45.00 |
- 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
- $2.88 / $3.78 / $3.78
| Professional | | $2.88 | $3.78 | $3.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.27 / $2.27 / $4.43
| Facility | | $2.27 | $2.27 | $4.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.93 / $1.93 / $2.67
| Professional | | $1.93 | $1.93 | $2.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.48 / $5.12
| Professional | | $2.00 | $3.48 | $5.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $2.70 / $3.78
| Professional | | $2.25 | $2.70 | $3.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.85 / $1.85 / $2.95
| Facility | | $1.85 | $1.85 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.04 / $2.16 / $2.88
| Professional | | $1.04 | $2.16 | $2.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.65 / $891.65 / $891.65
| Facility | | $891.65 | $891.65 | $891.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.20 / $5.20 / $7.40
| Professional | | $2.20 | $5.20 | $7.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.27 / $2.27 / $4.43
| Facility | | $2.27 | $2.27 | $4.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.93 / $1.93 / $4.50
| Professional | | $1.93 | $1.93 | $4.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.71 / $3.60 / $3.60
| Facility | | $2.71 | $3.60 | $3.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.71 / $3.60 / $3.60
| Professional | | $2.71 | $3.60 | $3.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.29 / $1.88 / $3.41
| Professional | | $1.29 | $1.88 | $3.41 |