- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.71 / $0.78 / $1.29
| Facility | | $0.71 | $0.78 | $1.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $1.00 / $3.39
| Professional | | $1.00 | $1.00 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.66 / $1.66 / $1.66
| Professional | | $1.66 | $1.66 | $1.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $1.00 / $2.69
| Facility | | $1.00 | $1.00 | $2.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.85 / $0.85 / $0.85
| Professional | | $0.85 | $0.85 | $0.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $2.45 / $3.72
| Professional | | $1.78 | $2.45 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.70 / $1.70 / $1.70
| Facility | | $1.70 | $1.70 | $1.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.85 / $0.98 / $1.70
| Professional | | $0.85 | $0.98 | $1.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.68 / $6.92 / $10.00
| Facility | | $4.68 | $6.92 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.71 / $0.78 / $1.29
| Facility | | $0.71 | $0.78 | $1.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $1.00 / $2.14
| Professional | | $1.00 | $1.00 | $2.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.69 / $2.69 / $2.69
| Facility | | $2.69 | $2.69 | $2.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.60 / $2.29 / $3.31
| Professional | | $0.60 | $2.29 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.20 / $1.20 / $1.58
| Facility | | $1.20 | $1.20 | $1.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.20 / $1.58 / $1.78
| Professional | | $1.20 | $1.58 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.65 / $0.83 / $1.38
| Professional | | $0.65 | $0.83 | $1.38 |