- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.20 / $1.50 / $7.80
| Facility | | $1.20 | $1.50 | $7.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.20 / $1.65 / $4.50
| Professional | | $1.20 | $1.65 | $4.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $967.00 / $57,255.43 / $79,506.39
| Facility | | $967.00 | $57,255.43 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $2.45 / $2.45
| Professional | | $2.45 | $2.45 | $2.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.23 / $5.23 / $5.23
| Facility | | $5.23 | $5.23 | $5.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.25 / $1.25 / $1.25
| Professional | | $1.25 | $1.25 | $1.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $3.32 / $3.55
| Professional | | $2.57 | $3.32 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.86 / $8.86 / $8.86
| Facility | | $8.86 | $8.86 | $8.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.20 / $1.67 / $7.80
| Facility | | $1.20 | $1.67 | $7.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.35 / $1.91 / $4.95
| Professional | | $1.35 | $1.91 | $4.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $4.80 / $4.80
| Professional | | $2.40 | $4.80 | $4.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.23 / $5.23 / $5.23
| Facility | | $5.23 | $5.23 | $5.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.25 / $1.25 / $1.25
| Professional | | $1.25 | $1.25 | $1.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.13 / $2.33 / $2.33
| Facility | | $2.13 | $2.33 | $2.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.13 / $2.33 / $2.33
| Professional | | $2.13 | $2.33 | $2.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.87 / $1.24 / $2.45
| Professional | | $0.87 | $1.24 | $2.45 |