- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.85 / $6.47 / $6.75
| Facility | | $2.85 | $6.47 | $6.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.44 / $2.85 / $6.82
| Professional | | $1.44 | $2.85 | $6.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.27 / $3.52 / $5.01
| Professional | | $3.27 | $3.52 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.40 / $80.00 / $80.00
| Facility | | $4.40 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.63 / $4.44 / $25.25
| Professional | | $3.63 | $4.44 | $25.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.06 / $3.06 / $3.24
| Facility | | $3.06 | $3.06 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.60 / $2.60 / $3.60
| Professional | | $2.60 | $2.60 | $3.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.10 / $5.01 / $8.80
| Facility | | $3.10 | $5.01 | $8.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.10 / $5.12 / $9.10
| Professional | | $3.10 | $5.12 | $9.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $3.86 / $4.24
| Professional | | $3.47 | $3.86 | $4.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.51 / $4.90 / $5.01
| Facility | | $4.51 | $4.90 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.40 / $5.01 / $5.01
| Professional | | $4.40 | $5.01 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.17 / $4.40 / $8.11
| Facility | | $4.17 | $4.40 | $8.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.17 / $4.75 / $7.22
| Professional | | $4.17 | $4.75 | $7.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $4.26 / $5.52
| Professional | | $4.00 | $4.26 | $5.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $2.33 / $4.12
| Professional | | $2.06 | $2.33 | $4.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $2.98 / $2.98
| Professional | | $2.56 | $2.98 | $2.98 |