- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.08 / $2.08 / $3.30
| Facility | | $2.08 | $2.08 | $3.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $2.60 / $3.39
| Professional | | $1.85 | $2.60 | $3.39 |
- 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
- $4.25 / $4.25 / $4.25
| Professional | | $4.25 | $4.25 | $4.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.98 / $4.98 / $4.98
| Facility | | $4.98 | $4.98 | $4.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.17 / $2.17 / $2.17
| Professional | | $2.17 | $2.17 | $2.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.46 / $5.75 / $6.16
| Professional | | $4.46 | $5.75 | $6.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.30 / $12.19 / $26.49
| Facility | | $7.30 | $12.19 | $26.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.08 / $2.08 / $3.30
| Facility | | $2.08 | $2.08 | $3.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.98 / $2.60 / $4.01
| Professional | | $1.98 | $2.60 | $4.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.10 / $6.10 / $8.40
| Professional | | $3.10 | $6.10 | $8.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.98 / $4.98 / $4.98
| Facility | | $4.98 | $4.98 | $4.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.17 / $2.17 / $2.17
| Professional | | $2.17 | $2.17 | $2.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.03 / $3.18 / $4.04
| Facility | | $3.03 | $3.18 | $4.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.03 / $4.04 / $4.04
| Professional | | $3.03 | $4.04 | $4.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.66 / $2.12 / $4.90
| Professional | | $1.66 | $2.12 | $4.90 |