- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.20 / $2.88 / $10.47
| Facility | | $1.20 | $2.88 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $1.07 / $3.02
| Professional | | $1.00 | $1.07 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $1.07 / $1.07
| Professional | | $1.07 | $1.07 | $1.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.07 / $1.07 / $1.12
| Facility | | $1.07 | $1.07 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $1.07 / $1.07
| Professional | | $1.07 | $1.07 | $1.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.02 / $1.02 / $85.11
| Facility | | $1.02 | $1.02 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $1.07 / $4.68
| Professional | | $1.07 | $1.07 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.89 / $1.17 / $3.24
| Facility | | $0.89 | $1.17 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.02 / $1.02 / $1.74
| Professional | | $1.02 | $1.02 | $1.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.10 / $1.10 / $1.12
| Facility | | $1.10 | $1.10 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.10 / $1.10 / $1.12
| Professional | | $1.10 | $1.10 | $1.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.12 / $2.24 / $4.68
| Facility | | $1.12 | $2.24 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.29 / $50,118.72 / $75,857.76
| Facility | | $1.29 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $1.12 / $1.86
| Professional | | $1.07 | $1.12 | $1.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.10 / $1.10 / $1.29
| Facility | | $1.10 | $1.10 | $1.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.36 / $1.10 / $1.32
| Professional | | $0.36 | $1.10 | $1.32 |