- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.06 / $2.92 / $4.98
| Facility | | $2.06 | $2.92 | $4.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $2.92 / $4.50
| Professional | | $2.06 | $2.92 | $4.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.82 / $1.82 / $7.59
| Professional | | $1.82 | $1.82 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.69 / $3.97 / $3.97
| Facility | | $3.69 | $3.97 | $3.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.97 / $3.97 / $3.97
| Professional | | $3.97 | $3.97 | $3.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.58 / $5.58 / $5.58
| Facility | | $5.58 | $5.58 | $5.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.94 / $1.94 / $1.94
| Professional | | $1.94 | $1.94 | $1.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.76 / $8.71 / $332.00
| Facility | | $4.76 | $8.71 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.76 / $6.43 / $10.33
| Professional | | $4.76 | $6.43 | $10.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.74 / $3.36 / $3.36
| Facility | | $2.74 | $3.36 | $3.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.74 / $2.91 / $3.36
| Professional | | $2.74 | $2.91 | $3.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.58 / $5.58 / $597.00
| Facility | | $5.58 | $5.58 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.94 / $1.94 / $32.00
| Professional | | $1.94 | $1.94 | $32.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.58 / $2.86 / $6.00
| Professional | | $1.58 | $2.86 | $6.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.74 / $2.74 / $3.39
| Facility | | $2.74 | $2.74 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.74 / $2.91 / $3.36
| Professional | | $2.74 | $2.91 | $3.36 |