- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.47 / $4.90 / $10.00
| Facility | | $3.47 | $4.90 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.02 / $4.79
| Professional | | $3.02 | $3.02 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $3.47 / $3.47
| Professional | | $3.47 | $3.47 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.09 / $3.09 / $3.24
| Facility | | $3.09 | $3.09 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.09 / $3.09 / $3.09
| Professional | | $3.09 | $3.09 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.24 / $3.24 / $85.11
| Facility | | $3.24 | $3.24 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $3.47 / $15.85
| Professional | | $3.47 | $3.47 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.24 / $4.17 / $11.75
| Facility | | $3.24 | $4.17 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $3.72 / $6.31
| Professional | | $3.72 | $3.72 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.72 / $3.72 / $3.89
| Facility | | $3.72 | $3.72 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $3.72 / $3.80
| Professional | | $3.72 | $3.72 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.17 / $1.51 / $4.90
| Facility | | $1.17 | $1.51 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.47 / $50,118.72 / $75,857.76
| Facility | | $4.47 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.09 / $3.47 / $5.37
| Professional | | $3.09 | $3.47 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.72 / $3.72 / $4.37
| Facility | | $3.72 | $3.72 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.95 / $3.72 / $4.47
| Professional | | $0.95 | $3.72 | $4.47 |