- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.53 / $5.53 / $5.97
| Facility | | $5.53 | $5.53 | $5.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.21 / $5.97 / $11.05
| Professional | | $5.21 | $5.97 | $11.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.47 / $9.47 / $9.47
| Professional | | $9.47 | $9.47 | $9.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,456.92 / $5,821.21 / $8,577.84
| Facility | | $5,456.92 | $5,821.21 | $8,577.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.01 / $6.01 / $7.51
| Professional | | $6.01 | $6.01 | $7.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.62 / $66.30 / $66.30
| Facility | | $12.62 | $66.30 | $66.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.14 / $7.14 / $7.14
| Facility | | $7.14 | $7.14 | $7.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.21 / $5.21 / $5.21
| Professional | | $5.21 | $5.21 | $5.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.36 / $73.36 / $82.88
| Professional | | $73.36 | $73.36 | $82.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.56 / $8.78 / $12.62
| Facility | | $3.56 | $8.78 | $12.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.60 / $11.61 / $14.73
| Professional | | $3.60 | $11.61 | $14.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.56 / $8.43 / $12.62
| Facility | | $3.56 | $8.43 | $12.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.21 / $5.21 / $11.82
| Professional | | $5.21 | $5.21 | $11.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.59 / $7.70 / $8.49
| Facility | | $4.59 | $7.70 | $8.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.59 / $6.79 / $8.43
| Professional | | $4.59 | $6.79 | $8.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.68 / $6.68 / $12.62
| Professional | | $6.68 | $6.68 | $12.62 |