- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.62 / $4.53 / $6.73
| Facility | | $3.62 | $4.53 | $6.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.62 / $2.71 / $3.48
| Professional | | $2.62 | $2.71 | $3.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.49 / $7.85 / $8.31
| Facility | | $6.49 | $7.85 | $8.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.49 / $1.49 / $12.49
| Professional | | $1.49 | $1.49 | $12.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.02 / $8.19 / $8.51
| Facility | | $2.02 | $8.19 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.02 / $3.02
| Professional | | $3.02 | $3.02 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.11 / $9.48 / $14.54
| Facility | | $8.11 | $9.48 | $14.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.30 / $8.13 / $9.24
| Professional | | $3.30 | $8.13 | $9.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.68 / $2.68 / $3.62
| Facility | | $2.68 | $2.68 | $3.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.48 / $2.72 / $100.00
| Facility | | $2.48 | $2.72 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.76 / $3.02 / $8.36
| Professional | | $1.76 | $3.02 | $8.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.51 / $5.91 / $85.00
| Professional | | $1.51 | $5.91 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.68 / $2.68 / $3.62
| Facility | | $2.68 | $2.68 | $3.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.69 / $7.13 / $30.75
| Professional | | $3.69 | $7.13 | $30.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.04 / $6.04 / $100.00
| Facility | | $6.04 | $6.04 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.60 / $1.96 / $2.87
| Professional | | $1.60 | $1.96 | $2.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.43 / $6.43 / $7.31
| Professional | | $6.43 | $6.43 | $7.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.31 / $7.31 / $16.48
| Professional | | $7.31 | $7.31 | $16.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.50 / $7.50 / $7.50
| Facility | | $7.50 | $7.50 | $7.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.51 / $2.52 / $8.82
| Professional | | $1.51 | $2.52 | $8.82 |