- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $3.09 / $3.09
| Facility | | $1.00 | $3.09 | $3.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $2.00 / $3.98
| Professional | | $1.00 | $2.00 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $3.98 / $3.98
| Professional | | $3.98 | $3.98 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.40 / $2.40 / $2.95
| Facility | | $2.40 | $2.40 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.04 / $2.82
| Professional | | $2.04 | $2.04 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.80 / $5.37 / $7.76
| Professional | | $3.80 | $5.37 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.07 / $4.07 / $4.07
| Facility | | $4.07 | $4.07 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $2.88 / $4.07
| Professional | | $2.45 | $2.88 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.80 / $3.80 / $3.80
| Professional | | $3.80 | $3.80 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $1.00 / $3.09
| Facility | | $1.00 | $1.00 | $3.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $2.00 / $3.98
| Professional | | $1.00 | $2.00 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.46 / $6.46 / $6.46
| Facility | | $6.46 | $6.46 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.60 / $5.75 / $7.94
| Professional | | $0.60 | $5.75 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.24 / $2.88 / $5.37
| Facility | | $2.24 | $2.88 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.51 / $3.80 / $5.37
| Professional | | $2.51 | $3.80 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.35 / $1.82 / $2.57
| Facility | | $1.35 | $1.82 | $2.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.32 / $2.00 / $4.07
| Professional | | $1.32 | $2.00 | $4.07 |