- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.00 / $3.89 / $97.72
| Facility | | $2.00 | $3.89 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.69 / $93.33
| Professional | | $2.00 | $2.69 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.62 / $7.41 / $223.87
| Facility | | $5.62 | $7.41 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $2.69 / $1,819.70
| Professional | | $2.24 | $2.69 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.69 / $2.69 / $5.37
| Facility | | $2.69 | $2.69 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $3.72 / $5.37
| Professional | | $2.24 | $3.72 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.69 / $2.69 / $2.69
| Facility | | $2.69 | $2.69 | $2.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.69 / $2.69 / $2.69
| Professional | | $2.69 | $2.69 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.24 / $56.23 / $8,511.38
| Facility | | $3.24 | $56.23 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $2.24 / $2.82
| Professional | | $2.24 | $2.24 | $2.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $102.33 / $199.53
| Facility | | $10.96 | $102.33 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.62 / $7.41 / $223.87
| Facility | | $5.62 | $7.41 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $2.69 / $1,819.70
| Professional | | $2.24 | $2.69 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $41.69 / $47.86
| Facility | | $5.25 | $41.69 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.39 / $3.39 / $45.71
| Professional | | $3.39 | $3.39 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.63 / $4.17 / $5.37
| Facility | | $2.63 | $4.17 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.63 / $2.69 / $4.57
| Professional | | $2.63 | $2.69 | $4.57 |