- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.27 / $12.02 / $34.67
| Facility | | $4.27 | $12.02 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $5.01 / $7.08
| Professional | | $3.02 | $5.01 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.08 / $18.20 / $33.88
| Facility | | $7.08 | $18.20 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $5.01 / $8.71
| Professional | | $3.55 | $5.01 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $6.46 / $6.46
| Facility | | $3.31 | $6.46 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $11.75 / $29.51
| Facility | | $5.25 | $11.75 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.09 / $3.63 / $9.77
| Professional | | $3.09 | $3.63 | $9.77 |
- 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
- $4.57 / $6.46 / $12.02
| Facility | | $4.57 | $6.46 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $5.50 / $7.08
| Professional | | $3.98 | $5.50 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.90 / $5.50 / $5.50
| Professional | | $4.90 | $5.50 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.57 / $6.46 / $18.20
| Facility | | $4.57 | $6.46 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $3.63 / $9.77
| Professional | | $3.16 | $3.63 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.34 / $3.55 / $6.46
| Facility | | $2.34 | $3.55 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $2.88 / $4.57
| Professional | | $2.75 | $2.88 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.51 / $2.51 / $6.46
| Professional | | $2.51 | $2.51 | $6.46 |