- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.96 / $3.96 / $4.96
| Facility | | $3.96 | $3.96 | $4.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.96 / $5.14 / $16.54
| Professional | | $3.96 | $5.14 | $16.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $967.00 / $57,255.43 / $79,506.39
| Facility | | $967.00 | $57,255.43 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.09 / $8.09 / $8.09
| Professional | | $8.09 | $8.09 | $8.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.48 / $9.48 / $9.48
| Facility | | $9.48 | $9.48 | $9.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.30 / $3.30 / $3.30
| Professional | | $3.30 | $3.30 | $3.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.49 / $10.95 / $11.73
| Professional | | $8.49 | $10.95 | $11.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.53 / $16.53 / $16.86
| Facility | | $16.53 | $16.53 | $16.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.96 / $3.96 / $4.96
| Facility | | $3.96 | $3.96 | $4.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.46 / $5.47 / $20.00
| Professional | | $4.46 | $5.47 | $20.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.90 / $11.50 / $15.90
| Professional | | $3.90 | $11.50 | $15.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.48 / $9.48 / $9.48
| Facility | | $9.48 | $9.48 | $9.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.30 / $3.30 / $3.30
| Professional | | $3.30 | $3.30 | $3.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.75 / $7.70 / $7.70
| Facility | | $4.75 | $7.70 | $7.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.75 / $7.70 / $7.70
| Professional | | $4.75 | $7.70 | $7.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.27 / $4.04 / $7.03
| Professional | | $3.27 | $4.04 | $7.03 |