- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.73 / $13.98 / $32.83
| Facility | | $4.73 | $13.98 | $32.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.61 / $2.72 / $4.00
| Professional | | $2.61 | $2.72 | $4.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.73 / $6.73 / $6.73
| Professional | | $6.73 | $6.73 | $6.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.82 / $7.06 / $60.00
| Facility | | $3.82 | $7.06 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.48 / $3.28 / $5.66
| Professional | | $1.48 | $3.28 | $5.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.06 / $7.47 / $14.98
| Facility | | $2.06 | $7.47 | $14.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $4.13 / $5.84
| Professional | | $2.06 | $4.13 | $5.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.59 / $3.51 / $3.86
| Professional | | $2.59 | $3.51 | $3.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.64 / $3.82 / $19.77
| Facility | | $3.64 | $3.82 | $19.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.64 / $5.46 / $10.01
| Facility | | $3.64 | $5.46 | $10.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.28 / $3.28 / $3.28
| Professional | | $3.28 | $3.28 | $3.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.19 / $5.97 / $10.01
| Facility | | $4.19 | $5.97 | $10.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $3.64 / $9.88
| Professional | | $2.73 | $3.64 | $9.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.64 / $4.37 / $4.37
| Facility | | $3.64 | $4.37 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.53 / $1.53 / $3.64
| Professional | | $1.53 | $1.53 | $3.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.64 / $1.64 / $1.89
| Professional | | $1.64 | $1.64 | $1.89 |