- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.37 / $8.38 / $51.49
| Facility | | $3.37 | $8.38 | $51.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.12 / $3.25 / $4.91
| Professional | | $3.12 | $3.25 | $4.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $2.15 / $2.49
| Professional | | $2.15 | $2.15 | $2.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.76 / $9.85 / $100.00
| Facility | | $3.76 | $9.85 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.77 / $3.37 / $6.80
| Professional | | $1.77 | $3.37 | $6.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.49 / $7.34 / $15.38
| Facility | | $2.49 | $7.34 | $15.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $4.55 / $7.30
| Professional | | $2.41 | $4.55 | $7.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.55 / $3.45 / $3.79
| Professional | | $2.55 | $3.45 | $3.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.58 / $3.76 / $8.19
| Facility | | $3.58 | $3.76 | $8.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.22 / $3.58 / $3.58
| Facility | | $3.22 | $3.58 | $3.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.22 / $3.22 / $3.22
| Professional | | $3.22 | $3.22 | $3.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.12 / $5.87 / $9.85
| Facility | | $4.12 | $5.87 | $9.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.69 / $3.58 / $9.88
| Professional | | $2.69 | $3.58 | $9.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.33 / $3.40 / $3.58
| Facility | | $2.33 | $3.40 | $3.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $2.15 / $4.01
| Professional | | $2.15 | $2.15 | $4.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $1.85 / $1.85
| Professional | | $1.85 | $1.85 | $1.85 |