- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.55 / $9.33 / $27.54
| Facility | | $3.55 | $9.33 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.98 / $5.62
| Professional | | $3.02 | $3.98 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.17 / $16.22 / $28.18
| Facility | | $6.17 | $16.22 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.50 / $6.76 / $7.08
| Professional | | $5.50 | $6.76 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.27 / $5.13 / $5.13
| Facility | | $4.27 | $5.13 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.17 / $9.12 / $22.91
| Facility | | $4.17 | $9.12 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $2.57 / $7.76
| Professional | | $2.34 | $2.57 | $7.76 |
- 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
- $3.63 / $4.90 / $9.33
| Facility | | $3.63 | $4.90 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.98 / $5.62
| Professional | | $3.02 | $3.98 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.80 / $4.27 / $4.27
| Professional | | $3.80 | $4.27 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.72 / $5.13 / $14.13
| Facility | | $3.72 | $5.13 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $2.69 / $7.59
| Professional | | $2.40 | $2.69 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.82 / $2.75 / $5.13
| Facility | | $1.82 | $2.75 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $2.19 / $3.72
| Professional | | $2.14 | $2.19 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $5.13
| Professional | | $2.00 | $2.00 | $5.13 |