- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.59 / $48.98 / $407.38
| Facility | | $7.59 | $48.98 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.32 / $4.47 / $15.14
| Professional | | $0.32 | $4.47 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.05 / $0.06 / $0.12
| Facility | | $0.05 | $0.06 | $0.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.05 / $0.05 / $0.21
| Professional | | $0.05 | $0.05 | $0.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.10 / $0.11 / $0.13
| Facility | | $0.10 | $0.11 | $0.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.05 / $0.07 / $0.20
| Professional | | $0.05 | $0.07 | $0.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.05 / $0.05 / $0.05
| Facility | | $0.05 | $0.05 | $0.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.05 / $0.05 / $0.05
| Professional | | $0.05 | $0.05 | $0.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.05 / $0.06 / $0.11
| Professional | | $0.05 | $0.06 | $0.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.07 / $0.07 / $0.07
| Professional | | $0.07 | $0.07 | $0.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.05 / $0.08 / $0.16
| Facility | | $0.05 | $0.08 | $0.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.05 / $0.05 / $0.11
| Professional | | $0.05 | $0.05 | $0.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.12 / $0.12 / $0.12
| Professional | | $0.12 | $0.12 | $0.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.27 / $0.27 / $0.27
| Facility | | $0.27 | $0.27 | $0.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.05 / $0.05 / $0.14
| Professional | | $0.05 | $0.05 | $0.14 |