- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.54 / $3.54 / $4.42
| Facility | | $3.54 | $3.54 | $4.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.50 / $4.42 / $7.91
| Professional | | $3.50 | $4.42 | $7.91 |
- 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
- $7.22 / $7.22 / $7.22
| Professional | | $7.22 | $7.22 | $7.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.46 / $8.46 / $8.46
| Facility | | $8.46 | $8.46 | $8.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $2.95 / $2.95
| Professional | | $2.95 | $2.95 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.58 / $9.77 / $10.47
| Professional | | $7.58 | $9.77 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.58 / $293.58 / $293.58
| Facility | | $293.58 | $293.58 | $293.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.54 / $3.54 / $4.42
| Facility | | $3.54 | $3.54 | $4.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.37 / $4.42 / $9.03
| Professional | | $3.37 | $4.42 | $9.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.90 / $10.80 / $14.20
| Professional | | $8.90 | $10.80 | $14.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.46 / $8.46 / $8.46
| Facility | | $8.46 | $8.46 | $8.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $2.95 / $2.95
| Professional | | $2.95 | $2.95 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.24 / $6.87 / $6.87
| Facility | | $4.24 | $6.87 | $6.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.24 / $6.87 / $6.87
| Professional | | $4.24 | $6.87 | $6.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.06 / $3.60 / $6.00
| Professional | | $3.06 | $3.60 | $6.00 |