- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.00 / $5.01 / $12.59
| Facility | | $2.00 | $5.01 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.98 / $10.72
| Professional | | $2.00 | $3.98 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.22 / $11.22 / $29.51
| Facility | | $11.22 | $11.22 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $8.71
| Professional | | $2.00 | $2.00 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.01 / $5.01 / $5.01
| Facility | | $5.01 | $5.01 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.63 / $5.01 / $5.01
| Professional | | $3.63 | $5.01 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.24 / $12.59 / $27.54
| Facility | | $7.24 | $12.59 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.63 / $2.63 / $53.70
| Professional | | $2.63 | $2.63 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $11.22 / $25.70
| Facility | | $3.31 | $11.22 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.57 / $11.22 / $32.36
| Professional | | $4.57 | $11.22 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $9.12 / $11.75
| Professional | | $3.16 | $9.12 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.37 / $20.42 / $50,118.72
| Facility | | $4.37 | $20.42 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.63 / $10.23 / $13.49
| Facility | | $2.63 | $10.23 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $3.02 / $7.76
| Professional | | $2.09 | $3.02 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.46 / $12.02 / $12.02
| Facility | | $6.46 | $12.02 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.39 / $9.33 / $12.02
| Professional | | $3.39 | $9.33 | $12.02 |