- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $6.38 / $11.23
| Facility | | $2.81 | $6.38 | $11.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.75 / $2.81 / $4.01
| Professional | | $1.75 | $2.81 | $4.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.01 / $4.01 / $10.43
| Facility | | $4.01 | $4.01 | $10.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.14 / $2.06 / $6.06
| Professional | | $1.14 | $2.06 | $6.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.41 / $4.01 / $4.01
| Facility | | $2.41 | $4.01 | $4.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.93 / $4.01 / $4.01
| Professional | | $2.93 | $4.01 | $4.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $7.77 / $28.21
| Facility | | $2.81 | $7.77 | $28.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.82 / $3.82 / $19.32
| Professional | | $1.82 | $3.82 | $19.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.50 / $5.21 / $332.00
| Facility | | $1.50 | $5.21 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.60 / $2.41 / $7.34
| Professional | | $1.60 | $2.41 | $7.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.13 / $3.25 / $4.20
| Professional | | $2.13 | $3.25 | $4.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.69 / $9.36 / $50.00
| Facility | | $4.69 | $9.36 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.88 / $3.96 / $6.22
| Professional | | $1.88 | $3.96 | $6.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.94 / $2.41 / $6.90
| Professional | | $1.94 | $2.41 | $6.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.61 / $4.61 / $8.72
| Facility | | $4.61 | $4.61 | $8.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.13 / $3.25 / $4.82
| Professional | | $2.13 | $3.25 | $4.82 |