- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.55 / $10.35 / $10.81
| Facility | | $4.55 | $10.35 | $10.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.46 / $4.55 / $10.93
| Professional | | $3.46 | $4.55 | $10.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.84 / $75.00 / $75.00
| Facility | | $6.84 | $75.00 | $75.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.64 / $7.09 / $40.09
| Professional | | $5.64 | $7.09 | $40.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.84 / $4.84 / $4.84
| Facility | | $4.84 | $4.84 | $4.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.12 / $4.12 / $5.99
| Professional | | $4.12 | $4.12 | $5.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.36 / $8.21 / $13.72
| Facility | | $6.36 | $8.21 | $13.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.36 / $8.65 / $14.75
| Professional | | $6.36 | $8.65 | $14.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.57 / $6.19 / $6.80
| Professional | | $5.57 | $6.19 | $6.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.25 / $7.86 / $8.05
| Facility | | $7.25 | $7.86 | $8.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.05 / $8.05 / $8.86
| Professional | | $7.05 | $8.05 | $8.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.68 / $7.05 / $13.03
| Facility | | $6.68 | $7.05 | $13.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.68 / $7.62 / $11.57
| Professional | | $6.68 | $7.62 | $11.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.41 / $6.84 / $8.86
| Professional | | $6.41 | $6.84 | $8.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.19 / $3.67 / $6.51
| Professional | | $3.19 | $3.67 | $6.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.16 / $4.16 / $4.16
| Professional | | $4.16 | $4.16 | $4.16 |