- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.47 / $56.88 / $99.97
| Facility | | $2.47 | $56.88 | $99.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $2.50 / $84.46
| Professional | | $2.47 | $2.50 | $84.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.53 / $8.18 / $2,976.31
| Facility | | $3.53 | $8.18 | $2,976.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $2.59 / $542.05
| Professional | | $2.47 | $2.59 | $542.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.65 / $3.03 / $5.89
| Facility | | $2.65 | $3.03 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.94 / $4.05 / $5.13
| Professional | | $2.94 | $4.05 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.47 / $2.47 / $2.47
| Facility | | $2.47 | $2.47 | $2.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $2.47 / $3.14
| Professional | | $2.47 | $2.47 | $3.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.94 / $83.43 / $8,090.00
| Facility | | $2.94 | $83.43 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $2.47 / $2.47
| Professional | | $2.47 | $2.47 | $2.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $2.47 / $2.86
| Professional | | $2.47 | $2.47 | $2.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.61 / $105.03 / $680.23
| Facility | | $34.61 | $105.03 | $680.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $2,976.31 / $2,976.31
| Facility | | $75.00 | $2,976.31 | $2,976.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $2.62 / $542.05
| Professional | | $2.47 | $2.62 | $542.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.88 / $5.25 / $6.42
| Facility | | $3.88 | $5.25 | $6.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $2.62 / $7.67
| Professional | | $2.47 | $2.62 | $7.67 |