- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.26 / $6.61 / $642.12
| Facility | | $3.26 | $6.61 | $642.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.29 / $111.90
| Professional | | $3.26 | $3.29 | $111.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.02 / $3.54 / $8,459.92
| Facility | | $3.02 | $3.54 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.38 / $3.38 / $3.38
| Professional | | $3.38 | $3.38 | $3.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.08 / $3.26 / $3.26
| Facility | | $3.08 | $3.26 | $3.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.26 / $3.38
| Professional | | $3.26 | $3.26 | $3.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.39 / $3.54 / $4.37
| Professional | | $3.39 | $3.54 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.48 / $6.48 / $6.48
| Facility | | $6.48 | $6.48 | $6.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.15 / $7.30 / $850.28
| Facility | | $3.15 | $7.30 | $850.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $3.59 / $91.30
| Professional | | $3.15 | $3.59 | $91.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.42 / $1,286.42 / $1,286.42
| Facility | | $1,286.42 | $1,286.42 | $1,286.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.82 / $6.40 / $6.40
| Professional | | $4.82 | $6.40 | $6.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.08 / $3.26 / $3.26
| Facility | | $3.08 | $3.26 | $3.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.26 / $3.38
| Professional | | $3.26 | $3.26 | $3.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.86 / $2.86 / $3.32
| Facility | | $2.86 | $2.86 | $3.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.86 / $2.86 / $3.32
| Professional | | $2.86 | $2.86 | $3.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.46 / $4.50
| Professional | | $3.26 | $3.46 | $4.50 |