- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.58 / $2.09 / $4.27
| Facility | | $1.58 | $2.09 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $1.00 / $2.19
| Professional | | $1.00 | $1.00 | $2.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.58 / $1.58 / $1.66
| Facility | | $1.58 | $1.58 | $1.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.58 / $1.58 / $1.58
| Professional | | $1.58 | $1.58 | $1.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.26 / $1.26 / $1.32
| Facility | | $1.26 | $1.26 | $1.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.26 / $1.26 / $1.26
| Professional | | $1.26 | $1.26 | $1.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.35 / $1.51 / $85.11
| Facility | | $1.35 | $1.51 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.58 / $1.58 / $7.08
| Professional | | $1.58 | $1.58 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.41 / $1.82 / $5.13
| Facility | | $1.41 | $1.82 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.55 / $1.55 / $2.45
| Professional | | $1.55 | $1.55 | $2.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.66 / $1.66 / $1.74
| Facility | | $1.66 | $1.66 | $1.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.66 / $1.66 / $1.70
| Professional | | $1.66 | $1.66 | $1.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.95 / $50,118.72 / $75,857.76
| Facility | | $1.95 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.58 / $1.58 / $1.58
| Facility | | $1.58 | $1.58 | $1.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.48 / $1.58 / $2.34
| Professional | | $1.48 | $1.58 | $2.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.66 / $1.66 / $1.95
| Facility | | $1.66 | $1.66 | $1.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.12 / $1.66 / $2.00
| Professional | | $1.12 | $1.66 | $2.00 |