- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.73 / $2.73 / $2.89
| Facility | | $2.73 | $2.73 | $2.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $2.89 / $3.75
| Professional | | $2.40 | $2.89 | $3.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.66 / $6.12 / $6.12
| Professional | | $4.66 | $6.12 | $6.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.51 / $3.51 / $6.12
| Facility | | $3.51 | $3.51 | $6.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.98 / $2.98 / $5.36
| Professional | | $2.98 | $2.98 | $5.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.63 / $6.12 / $11.63
| Professional | | $5.63 | $6.12 | $11.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.80 / $12.80 / $18.29
| Facility | | $12.80 | $12.80 | $18.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.73 / $2.73 / $2.73
| Facility | | $2.73 | $2.73 | $2.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $2.89 / $4.22
| Professional | | $2.40 | $2.89 | $4.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.60 / $8.69 / $12.10
| Professional | | $7.60 | $8.69 | $12.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.51 / $3.51 / $6.12
| Facility | | $3.51 | $3.51 | $6.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.98 / $2.98 / $7.13
| Professional | | $2.98 | $2.98 | $7.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.38 / $5.83 / $5.83
| Facility | | $4.38 | $5.83 | $5.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.38 / $5.83 / $5.97
| Professional | | $4.38 | $5.83 | $5.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.85 / $3.31 / $5.52
| Professional | | $2.85 | $3.31 | $5.52 |