- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.60 / $3.26 / $4.84
| Facility | | $2.60 | $3.26 | $4.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $2.52 / $2.98
| Professional | | $1.78 | $2.52 | $2.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.67 / $5.64 / $5.97
| Facility | | $4.67 | $5.64 | $5.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $1.07 / $8.91
| Professional | | $1.07 | $1.07 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.28 / $5.89 / $6.12
| Facility | | $1.28 | $5.89 | $6.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $7.37 / $11.31
| Facility | | $6.31 | $7.37 | $11.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $6.48 / $7.36
| Professional | | $2.48 | $6.48 | $7.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.93 / $1.93 / $2.60
| Facility | | $1.93 | $1.93 | $2.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.78 / $1.95 / $100.00
| Facility | | $1.78 | $1.95 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.30 / $2.60 / $5.86
| Professional | | $1.30 | $2.60 | $5.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.07 / $4.47 / $85.00
| Professional | | $1.07 | $4.47 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.93 / $1.93 / $2.60
| Facility | | $1.93 | $1.93 | $2.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.66 / $5.53 / $29.85
| Professional | | $2.66 | $5.53 | $29.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.34 / $4.34 / $100.00
| Facility | | $4.34 | $4.34 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.14 / $1.47 / $2.09
| Professional | | $1.14 | $1.47 | $2.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.23 / $2.23 / $4.62
| Professional | | $2.23 | $2.23 | $4.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.23 / $2.23 / $11.85
| Professional | | $2.23 | $2.23 | $11.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.30 / $2.39 / $4.87
| Professional | | $1.30 | $2.39 | $4.87 |