- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.94 / $2.72 / $4.65
| Facility | | $1.94 | $2.72 | $4.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.94 / $2.72 / $4.20
| Professional | | $1.94 | $2.72 | $4.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.13 / $4.23 / $6.61
| Professional | | $2.13 | $4.23 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.44 / $3.70 / $3.70
| Facility | | $3.44 | $3.70 | $3.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.70 / $3.70 / $3.70
| Professional | | $3.70 | $3.70 | $3.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $6.31 / $6.31
| Facility | | $6.31 | $6.31 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $2.27 / $2.27
| Professional | | $2.27 | $2.27 | $2.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.44 / $8.13 / $332.00
| Facility | | $4.44 | $8.13 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.44 / $6.01 / $9.63
| Professional | | $4.44 | $6.01 | $9.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.82 / $1.82 / $2.57
| Facility | | $1.82 | $1.82 | $2.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.82 / $2.57 / $2.73
| Professional | | $1.82 | $2.57 | $2.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $6.31 / $597.00
| Facility | | $6.31 | $6.31 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $2.27 / $7.60
| Professional | | $2.27 | $2.27 | $7.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.48 / $2.58 / $4.90
| Professional | | $1.48 | $2.58 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.57 / $2.57 / $3.18
| Facility | | $2.57 | $2.57 | $3.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.82 / $2.57 / $2.73
| Professional | | $1.82 | $2.57 | $2.73 |