- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.64 / $1.85 / $3.57
| Facility | | $1.64 | $1.85 | $3.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.64 / $1.92 / $3.57
| Professional | | $1.64 | $1.92 | $3.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.89 / $2.49 / $7.00
| Professional | | $1.89 | $2.49 | $7.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.93 / $3.15 / $3.15
| Facility | | $2.93 | $3.15 | $3.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $3.15 / $3.15
| Professional | | $3.15 | $3.15 | $3.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.27 / $2.27 / $2.80
| Facility | | $2.27 | $2.27 | $2.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.93 / $1.93 / $2.80
| Professional | | $1.93 | $1.93 | $2.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.78 / $8.51 / $332.00
| Facility | | $3.78 | $8.51 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.23 / $3.78 / $6.80
| Professional | | $2.23 | $3.78 | $6.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.87 / $2.87 / $2.87
| Facility | | $2.87 | $2.87 | $2.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $2.73 / $3.15
| Professional | | $2.73 | $2.73 | $3.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.27 / $2.27 / $555.00
| Facility | | $2.27 | $2.27 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.93 / $2.31 / $5.63
| Professional | | $1.93 | $2.31 | $5.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.26 / $1.88 / $3.17
| Professional | | $1.26 | $1.88 | $3.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.16 / $2.73 / $2.73
| Facility | | $2.16 | $2.73 | $2.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $2.73 / $2.87
| Professional | | $2.73 | $2.73 | $2.87 |