- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.90 / $1.02 / $1.13
| Facility | | $0.90 | $1.02 | $1.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.90 / $1.02 / $1.09
| Professional | | $0.90 | $1.02 | $1.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.37 / $1.37 / $2.74
| Facility | | $1.37 | $1.37 | $2.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.28 / $1.44 / $2.47
| Professional | | $1.28 | $1.44 | $2.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.68 / $1.68 / $1.70
| Facility | | $1.68 | $1.68 | $1.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.68 / $1.68 / $1.68
| Professional | | $1.68 | $1.68 | $1.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $2.47 / $2.47
| Professional | | $2.47 | $2.47 | $2.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.37 / $2.88 / $332.00
| Facility | | $1.37 | $2.88 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.37 / $2.50 / $3.81
| Professional | | $1.37 | $2.50 | $3.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.63 / $1.87 / $1.87
| Facility | | $1.63 | $1.87 | $1.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.63 / $1.73 / $1.87
| Professional | | $1.63 | $1.73 | $1.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $597.00 / $74,999.25
| Facility | | $555.00 | $597.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.83 / $2.47 / $2.78
| Professional | | $0.83 | $2.47 | $2.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.54 / $1.77 / $3.15
| Professional | | $0.54 | $1.77 | $3.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.63 / $1.63 / $1.79
| Facility | | $1.63 | $1.63 | $1.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.63 / $1.73 / $1.79
| Professional | | $1.63 | $1.73 | $1.79 |