- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.16 / $4.90 / $5.12
| Facility | | $2.16 | $4.90 | $5.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.64 / $2.16 / $5.18
| Professional | | $1.64 | $2.16 | $5.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.34 / $80.00 / $80.00
| Facility | | $3.34 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.71 / $3.37 / $18.97
| Professional | | $2.71 | $3.37 | $18.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.29 / $2.29 / $2.42
| Facility | | $2.29 | $2.29 | $2.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.95 / $1.95 / $2.69
| Professional | | $1.95 | $1.95 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.17 / $3.81 / $6.30
| Facility | | $2.17 | $3.81 | $6.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.17 / $3.89 / $6.62
| Professional | | $2.17 | $3.89 | $6.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.62 / $2.92 / $3.21
| Professional | | $2.62 | $2.92 | $3.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.43 / $3.72 / $3.81
| Facility | | $3.43 | $3.72 | $3.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.43 / $3.81 / $4.19
| Professional | | $3.43 | $3.81 | $4.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.16 / $3.34 / $6.17
| Facility | | $3.16 | $3.34 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $3.61 / $5.48
| Professional | | $3.16 | $3.61 | $5.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.03 / $3.24 / $4.19
| Professional | | $3.03 | $3.24 | $4.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.50 / $1.61 / $3.09
| Professional | | $1.50 | $1.61 | $3.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.62 / $1.62 / $1.91
| Professional | | $1.62 | $1.62 | $1.91 |