- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.23 / $1.62 / $3.31
| Facility | | $1.23 | $1.62 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $1.00 / $1.48
| Professional | | $1.00 | $1.00 | $1.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.23 / $1.23 / $1.29
| Facility | | $1.23 | $1.23 | $1.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.23 / $1.23 / $1.23
| Professional | | $1.23 | $1.23 | $1.23 |
- 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 / $1.10
| Professional | | $1.10 | $1.10 | $1.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.15 / $1.15 / $1.66
| Facility | | $1.15 | $1.15 | $1.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.23 / $1.23 / $5.25
| Professional | | $1.23 | $1.23 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.17 / $1.51 / $4.27
| Facility | | $1.17 | $1.51 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.35 / $1.35 / $1.41
| Professional | | $1.35 | $1.35 | $1.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.23 / $1.23 / $1.29
| Facility | | $1.23 | $1.23 | $1.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.23 / $1.23 / $1.26
| Professional | | $1.23 | $1.23 | $1.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.55 / $50,118.72 / $75,857.76
| Facility | | $1.55 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.23 / $1.23 / $1.23
| Facility | | $1.23 | $1.23 | $1.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.12 / $1.23 / $1.74
| Professional | | $1.12 | $1.23 | $1.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.23 / $1.23 / $1.45
| Facility | | $1.23 | $1.23 | $1.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.23 / $1.26 / $1.48
| Professional | | $1.23 | $1.26 | $1.48 |