- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.81 / $4.51 / $8.27
| Facility | | $3.81 | $4.51 | $8.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $4.51 / $8.27
| Professional | | $2.54 | $4.51 | $8.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $4.00 / $12.20
| Professional | | $4.00 | $4.00 | $12.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.78 / $7.29 / $7.29
| Facility | | $6.78 | $7.29 | $7.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.29 / $7.29 / $7.29
| Professional | | $7.29 | $7.29 | $7.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.00 / $5.57 / $5.57
| Facility | | $4.00 | $5.57 | $5.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.73 / $4.73 / $6.36
| Professional | | $4.73 | $4.73 | $6.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.76 / $19.71 / $332.00
| Facility | | $8.76 | $19.71 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.51 / $6.86 / $16.03
| Professional | | $4.51 | $6.86 | $16.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.17 / $4.17 / $4.17
| Facility | | $4.17 | $4.17 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.17 / $5.07 / $6.28
| Professional | | $4.17 | $5.07 | $6.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.00 / $5.57 / $555.00
| Facility | | $4.00 | $5.57 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.73 / $5.39 / $13.05
| Professional | | $4.73 | $5.39 | $13.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.91 / $4.59 / $8.01
| Professional | | $2.91 | $4.59 | $8.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.07 / $5.07 / $6.28
| Facility | | $5.07 | $5.07 | $6.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.17 / $5.07 / $5.39
| Professional | | $4.17 | $5.07 | $5.39 |