- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $8.71 / $24.55
| Facility | | $3.31 | $8.71 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.02 / $5.13
| Professional | | $2.00 | $3.02 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.24 / $18.20 / $20.42
| Facility | | $7.24 | $18.20 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $5.01 / $5.50
| Professional | | $2.57 | $5.01 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.27 / $4.68 / $4.68
| Facility | | $4.27 | $4.68 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.80 / $8.51 / $21.88
| Facility | | $3.80 | $8.51 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $2.57 / $7.24
| Professional | | $2.34 | $2.57 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $100.00 / $100.00
| Facility | | $70.79 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.39 / $4.68 / $8.71
| Facility | | $3.39 | $4.68 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.98 / $5.01
| Professional | | $2.00 | $3.98 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $3.98 / $3.98
| Professional | | $3.55 | $3.98 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.39 / $4.68 / $13.18
| Facility | | $3.39 | $4.68 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $2.69 / $7.08
| Professional | | $2.40 | $2.69 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.70 / $2.57 / $4.68
| Facility | | $1.70 | $2.57 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $3.02 / $4.68
| Professional | | $2.40 | $3.02 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.82 / $1.82 / $4.68
| Professional | | $1.82 | $1.82 | $4.68 |