- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.35 / $3.76 / $7.28
| Facility | | $3.35 | $3.76 | $7.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.10 / $3.76 / $7.28
| Professional | | $2.10 | $3.76 | $7.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.85 / $5.08 / $10.35
| Professional | | $3.85 | $5.08 | $10.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.96 / $6.41 / $6.41
| Facility | | $5.96 | $6.41 | $6.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.41 / $6.41 / $6.41
| Professional | | $6.41 | $6.41 | $6.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.62 / $4.62 / $5.71
| Facility | | $4.62 | $4.62 | $5.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.93 / $3.93 / $5.71
| Professional | | $3.93 | $3.93 | $5.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.70 / $17.32 / $332.00
| Facility | | $7.70 | $17.32 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.54 / $5.83 / $13.63
| Professional | | $4.54 | $5.83 | $13.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.83 / $5.83 / $5.83
| Facility | | $5.83 | $5.83 | $5.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.56 / $5.56 / $6.41
| Professional | | $5.56 | $5.56 | $6.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.93 / $4.93 / $4.93
| Professional | | $4.93 | $4.93 | $4.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.62 / $4.62 / $555.00
| Facility | | $4.62 | $4.62 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.93 / $4.72 / $11.25
| Professional | | $3.93 | $4.72 | $11.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $3.84 / $6.55
| Professional | | $2.56 | $3.84 | $6.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.50 / $5.56 / $5.56
| Facility | | $5.50 | $5.56 | $5.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.56 / $5.56 / $5.83
| Professional | | $5.56 | $5.56 | $5.83 |