- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.67 / $8.31 / $13.80
| Facility | | $3.67 | $8.31 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.53 / $4.13 / $4.75
| Professional | | $3.53 | $4.13 | $4.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.75 / $4.75 / $12.35
| Facility | | $4.75 | $4.75 | $12.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.16 / $2.87 / $10.71
| Professional | | $2.16 | $2.87 | $10.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.85 / $4.75 / $4.75
| Facility | | $2.85 | $4.75 | $4.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $4.75 / $4.75
| Professional | | $3.47 | $4.75 | $4.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.32 / $9.89 / $48.04
| Facility | | $3.32 | $9.89 | $48.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $5.48 / $22.90
| Professional | | $3.47 | $5.48 | $22.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.00 / $6.92 / $332.00
| Facility | | $4.00 | $6.92 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.90 / $2.85 / $8.69
| Professional | | $1.90 | $2.85 | $8.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.04 / $4.75 / $5.71
| Professional | | $4.04 | $4.75 | $5.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.93 / $11.91 / $62.80
| Facility | | $5.93 | $11.91 | $62.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.60 / $5.29 / $9.78
| Professional | | $3.60 | $5.29 | $9.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.85 / $7.79
| Professional | | $2.00 | $2.85 | $7.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.46 / $5.46 / $17.52
| Facility | | $5.46 | $5.46 | $17.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.18 / $5.26 / $6.31
| Professional | | $4.18 | $5.26 | $6.31 |