- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.18 / $7.96 / $23.27
| Facility | | $3.18 | $7.96 | $23.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $3.72 / $5.12
| Professional | | $2.56 | $3.72 | $5.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.04 / $2.56
| Professional | | $2.04 | $2.04 | $2.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.00 / $13.49 / $23.95
| Facility | | $5.00 | $13.49 | $23.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $4.18 / $5.50
| Professional | | $2.25 | $4.18 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.26 / $6.41 / $25.57
| Facility | | $4.26 | $6.41 | $25.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.26 / $4.26 / $4.92
| Facility | | $4.26 | $4.26 | $4.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.98 / $9.34 / $19.64
| Facility | | $2.98 | $9.34 | $19.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $3.12 / $7.11
| Professional | | $2.25 | $3.12 | $7.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.02 / $70.00 / $70.00
| Facility | | $14.02 | $70.00 | $70.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.42 / $4.26 / $5.55
| Facility | | $3.42 | $4.26 | $5.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.97 / $4.26 / $5.57
| Professional | | $3.97 | $4.26 | $5.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.42 / $4.26 / $10.54
| Facility | | $3.42 | $4.26 | $10.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $3.29 / $6.17
| Professional | | $2.25 | $3.29 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $3.49 / $4.70
| Professional | | $2.56 | $3.49 | $4.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.67 / $2.11 / $4.26
| Professional | | $1.67 | $2.11 | $4.26 |