- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.54 / $2.85 / $5.54
| Facility | | $2.54 | $2.85 | $5.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $2.85 / $5.54
| Professional | | $2.54 | $2.85 | $5.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.93 / $2.93 / $8.65
| Professional | | $2.93 | $2.93 | $8.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.54 / $4.88 / $4.88
| Facility | | $4.54 | $4.88 | $4.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.88 / $4.88 / $4.88
| Professional | | $4.88 | $4.88 | $4.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.77 / $3.77 / $3.88
| Facility | | $3.77 | $3.77 | $3.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $3.20 / $3.88
| Professional | | $2.40 | $3.20 | $3.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.87 / $13.21 / $332.00
| Facility | | $5.87 | $13.21 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.38 / $4.40 / $10.74
| Professional | | $3.38 | $4.40 | $10.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.23 / $4.23 / $4.23
| Facility | | $4.23 | $4.23 | $4.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.22 / $4.22 / $4.88
| Professional | | $4.22 | $4.22 | $4.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.77 / $3.77 / $555.00
| Facility | | $3.77 | $3.77 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $3.20 / $6.75
| Professional | | $2.40 | $3.20 | $6.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.95 / $2.92 / $5.36
| Professional | | $1.95 | $2.92 | $5.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.18 / $4.22 / $4.22
| Facility | | $4.18 | $4.22 | $4.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.22 / $4.22 / $4.23
| Professional | | $4.22 | $4.22 | $4.23 |