- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $56.23 / $87.10
| Facility | | $1.00 | $56.23 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $1.00 / $1.00
| Professional | | $1.00 | $1.00 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $1.41 / $2.14
| Professional | | $1.41 | $1.41 | $2.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.41 / $3.09 / $5.37
| Facility | | $1.41 | $3.09 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $1.78 / $3.02
| Professional | | $1.41 | $1.78 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.32 / $1.41 / $2.88
| Facility | | $1.32 | $1.41 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.58 / $1.58 / $1.62
| Professional | | $1.58 | $1.58 | $1.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.32 / $2.88 / $19.05
| Facility | | $1.32 | $2.88 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $1.41 / $7.41
| Professional | | $1.41 | $1.41 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $50.12 / $85.11
| Professional | | $1.41 | $50.12 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $1.48 / $4.37
| Professional | | $1.41 | $1.48 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.41 / $1.41 / $100.00
| Facility | | $1.41 | $1.41 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $1.74 / $7.41
| Professional | | $1.41 | $1.74 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $1.86 / $2.29
| Professional | | $1.86 | $1.86 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.45 / $1.45 / $1.45
| Facility | | $1.45 | $1.45 | $1.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $1.41 / $2.14
| Professional | | $1.41 | $1.41 | $2.14 |