- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.13 / $8.57 / $31.50
| Facility | | $3.13 | $8.57 | $31.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.11 / $3.23 / $10.00
| Professional | | $3.11 | $3.23 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.94 / $542.60 / $1,161.73
| Facility | | $3.94 | $542.60 | $1,161.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.87 / $3.38 / $8,639.91
| Facility | | $2.87 | $3.38 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.23 / $3.23 / $3.23
| Professional | | $3.23 | $3.23 | $3.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.94 / $3.11 / $3.11
| Facility | | $2.94 | $3.11 | $3.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.11 / $3.11 / $3.11
| Professional | | $3.11 | $3.11 | $3.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.15 / $46.96 / $149.28
| Facility | | $6.15 | $46.96 | $149.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.94 / $4.63 / $1,115.40
| Facility | | $3.94 | $4.63 | $1,115.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.11 / $8.69 / $33.90
| Facility | | $3.11 | $8.69 | $33.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.07 / $3.81 / $10.00
| Professional | | $3.07 | $3.81 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.71 / $874.27 / $1,070.00
| Facility | | $776.71 | $874.27 | $1,070.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.94 / $3.11 / $3.11
| Facility | | $2.94 | $3.11 | $3.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.11 / $3.11 / $3.11
| Professional | | $3.11 | $3.11 | $3.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.50 / $3.50 / $4.05
| Facility | | $3.50 | $3.50 | $4.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.50 / $3.50 / $4.05
| Professional | | $3.50 | $3.50 | $4.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.11 / $3.11 / $5.36
| Professional | | $3.11 | $3.11 | $5.36 |