- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.20 / $2.69 / $3.52
| Facility | | $1.20 | $2.69 | $3.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.20 / $1.96 / $3.52
| Professional | | $1.20 | $1.96 | $3.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.89 / $2.37 / $5.31
| Professional | | $0.89 | $2.37 | $5.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.88 / $3.10 / $3.10
| Facility | | $2.88 | $3.10 | $3.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.10 / $3.10 / $3.10
| Professional | | $3.10 | $3.10 | $3.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.65 / $6.65 / $6.65
| Facility | | $6.65 | $6.65 | $6.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $2.24 / $2.24
| Professional | | $2.24 | $2.24 | $2.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.72 / $6.81 / $332.00
| Facility | | $3.72 | $6.81 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $5.01 / $8.07
| Professional | | $2.15 | $5.01 | $8.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.60 / $1.60 / $2.94
| Facility | | $1.60 | $1.60 | $2.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.60 / $2.94 / $3.12
| Professional | | $1.60 | $2.94 | $3.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.65 / $6.65 / $597.00
| Facility | | $6.65 | $6.65 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $2.24 / $6.37
| Professional | | $2.24 | $2.24 | $6.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.24 / $2.23 / $4.61
| Professional | | $1.24 | $2.23 | $4.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.94 / $2.94 / $8.66
| Facility | | $2.94 | $2.94 | $8.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.60 / $2.94 / $3.12
| Professional | | $1.60 | $2.94 | $3.12 |