- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.94 / $2.79 / $77.90
| Facility | | $1.94 | $2.79 | $77.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.79 / $2.79 / $3.71
| Professional | | $2.79 | $2.79 | $3.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.99 / $24.66 / $224.85
| Facility | | $6.99 | $24.66 | $224.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.79 / $2.93 / $1,837.68
| Professional | | $2.79 | $2.93 | $1,837.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.99 / $3.43 / $6.66
| Facility | | $2.99 | $3.43 | $6.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $4.69 / $6.07
| Professional | | $3.55 | $4.69 | $6.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.22 / $2.79 / $2.79
| Facility | | $2.22 | $2.79 | $2.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.79 / $2.79 / $2.79
| Professional | | $2.79 | $2.79 | $2.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.32 / $83.43 / $8,090.00
| Facility | | $3.32 | $83.43 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.79 / $2.79 / $2.79
| Professional | | $2.79 | $2.79 | $2.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.79 / $2.79 / $3.23
| Professional | | $2.79 | $2.79 | $3.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.85 / $102.49 / $165.09
| Facility | | $9.85 | $102.49 | $165.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $224.85 / $224.85
| Facility | | $75.00 | $224.85 | $224.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.79 / $2.96 / $1,837.68
| Professional | | $2.79 | $2.96 | $1,837.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.88 / $43.52 / $56.66
| Facility | | $1.88 | $43.52 | $56.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.57 / $2.16 / $52.39
| Professional | | $1.57 | $2.16 | $52.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.79 / $2.96 / $8.26
| Professional | | $2.79 | $2.96 | $8.26 |