- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $3.15 / $6.11
| Facility | | $2.81 | $3.15 | $6.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $3.31 / $6.11
| Professional | | $2.81 | $3.31 | $6.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.23 / $3.23 / $9.22
| Professional | | $3.23 | $3.23 | $9.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.01 / $5.39 / $5.39
| Facility | | $5.01 | $5.39 | $5.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.39 / $5.39 / $5.39
| Professional | | $5.39 | $5.39 | $5.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.88 / $3.88 / $3.88
| Facility | | $3.88 | $3.88 | $3.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.30 / $3.30 / $4.80
| Professional | | $3.30 | $3.30 | $4.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.46 / $14.54 / $332.00
| Facility | | $6.46 | $14.54 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.69 / $4.84 / $11.82
| Professional | | $3.69 | $4.84 | $11.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.57 / $3.57 / $3.57
| Facility | | $3.57 | $3.57 | $3.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.57 / $4.66 / $4.66
| Professional | | $3.57 | $4.66 | $4.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.88 / $3.88 / $555.00
| Facility | | $3.88 | $3.88 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.30 / $3.88 / $9.38
| Professional | | $3.30 | $3.88 | $9.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $3.23 / $5.57
| Professional | | $2.15 | $3.23 | $5.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.61 / $4.66 / $4.66
| Facility | | $4.61 | $4.66 | $4.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.57 / $4.66 / $4.66
| Professional | | $3.57 | $4.66 | $4.66 |