- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.85 / $2.52 / $4.46
| Facility | | $1.85 | $2.52 | $4.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.83 / $2.52 / $4.03
| Professional | | $1.83 | $2.52 | $4.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.88 / $1.88 / $6.82
| Professional | | $1.88 | $1.88 | $6.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.30 / $3.55 / $3.55
| Facility | | $3.30 | $3.55 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $3.55 / $3.55
| Professional | | $3.55 | $3.55 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.92 / $4.92 / $4.92
| Facility | | $4.92 | $4.92 | $4.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $2.18 / $2.18
| Professional | | $2.18 | $2.18 | $2.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.26 / $7.80 / $332.00
| Facility | | $4.26 | $7.80 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.26 / $5.75 / $9.24
| Professional | | $4.26 | $5.75 | $9.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.02 / $1.02 / $2.45
| Facility | | $1.02 | $1.02 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.02 / $2.45 / $2.61
| Professional | | $1.02 | $2.45 | $2.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.92 / $4.92 / $597.00
| Facility | | $4.92 | $4.92 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.18 / $7.29
| Professional | | $2.04 | $2.18 | $7.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $2.43 / $4.70
| Professional | | $1.42 | $2.43 | $4.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.45 / $2.45 / $3.04
| Facility | | $2.45 | $2.45 | $3.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.02 / $2.45 / $2.61
| Professional | | $1.02 | $2.45 | $2.61 |