- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.80 / $10.29 / $17.50
| Facility | | $4.80 | $10.29 | $17.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.20 / $3.90 / $5.88
| Professional | | $3.20 | $3.90 | $5.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.88 / $5.88 / $15.29
| Facility | | $5.88 | $5.88 | $15.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.10 / $2.99 / $10.32
| Professional | | $2.10 | $2.99 | $10.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.53 / $5.88 / $5.88
| Facility | | $3.53 | $5.88 | $5.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.29 / $5.88 / $5.88
| Professional | | $4.29 | $5.88 | $5.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.11 / $12.00 / $46.38
| Facility | | $4.11 | $12.00 | $46.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.32 / $5.84 / $29.91
| Professional | | $3.32 | $5.84 | $29.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.50 / $8.23 / $332.00
| Facility | | $4.50 | $8.23 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $3.53 / $10.76
| Professional | | $2.35 | $3.53 | $10.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.90 / $5.59 / $7.07
| Professional | | $3.90 | $5.59 | $7.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.70 / $14.70 / $14.70
| Facility | | $14.70 | $14.70 | $14.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.19 / $14.46 / $62.80
| Facility | | $7.19 | $14.46 | $62.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.36 / $6.61 / $9.50
| Professional | | $3.36 | $6.61 | $9.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $3.53 / $8.64
| Professional | | $2.47 | $3.53 | $8.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.76 / $6.76 / $12.07
| Facility | | $6.76 | $6.76 | $12.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.90 / $5.73 / $12.07
| Professional | | $3.90 | $5.73 | $12.07 |