- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.12 / $8.00 / $13.82
| Facility | | $4.12 | $8.00 | $13.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.43 / $3.33 / $4.84
| Professional | | $2.43 | $3.33 | $4.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.84 / $4.84 / $12.61
| Facility | | $4.84 | $4.84 | $12.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $2.47 / $8.81
| Professional | | $1.78 | $2.47 | $8.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.91 / $4.84 / $4.84
| Facility | | $2.91 | $4.84 | $4.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.54 / $4.84 / $4.84
| Professional | | $3.54 | $4.84 | $4.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.39 / $9.89 / $38.96
| Facility | | $3.39 | $9.89 | $38.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.82 / $4.75 / $23.38
| Professional | | $2.82 | $4.75 | $23.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.00 / $6.31 / $332.00
| Facility | | $2.00 | $6.31 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.94 / $2.91 / $8.88
| Professional | | $1.94 | $2.91 | $8.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.33 / $4.38 / $5.45
| Professional | | $3.33 | $4.38 | $5.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.93 / $11.91 / $51.08
| Facility | | $5.93 | $11.91 | $51.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.97 / $5.00 / $8.08
| Professional | | $2.97 | $5.00 | $8.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.91 / $7.28
| Professional | | $2.04 | $2.91 | $7.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.58 / $5.58 / $13.56
| Facility | | $5.58 | $5.58 | $13.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.33 / $4.61 / $5.83
| Professional | | $3.33 | $4.61 | $5.83 |