- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.31 / $2.31 / $3.70
| Facility | | $2.31 | $2.31 | $3.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.32 / $2.75 / $3.70
| Professional | | $1.32 | $2.75 | $3.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.08 / $2.08 / $2.08
| Professional | | $2.08 | $2.08 | $2.08 |
- 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
- $3.61 / $4.74 / $4.74
| Professional | | $3.61 | $4.74 | $4.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.85 / $2.85 / $5.56
| Facility | | $2.85 | $2.85 | $5.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.42 / $2.42 / $5.63
| Professional | | $2.42 | $2.42 | $5.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.36 / $4.74 / $9.01
| Professional | | $4.36 | $4.74 | $9.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.19 / $3.32 / $3.56
| Professional | | $3.19 | $3.32 | $3.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.31 / $2.31 / $3.70
| Facility | | $2.31 | $2.31 | $3.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.29 / $2.66 / $4.15
| Professional | | $1.29 | $2.66 | $4.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.80 / $6.70 / $9.30
| Professional | | $5.80 | $6.70 | $9.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.85 / $2.85 / $5.56
| Facility | | $2.85 | $2.85 | $5.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.42 / $2.42 / $5.68
| Professional | | $2.42 | $2.42 | $5.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.37 / $4.51 / $4.51
| Facility | | $3.37 | $4.51 | $4.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.37 / $4.51 / $4.51
| Professional | | $3.37 | $4.51 | $4.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.69 / $2.36 / $4.13
| Professional | | $1.69 | $2.36 | $4.13 |