- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.16 / $2.84 / $7.81
| Facility | | $2.16 | $2.84 | $7.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.32 / $2.80 / $3.79
| Professional | | $1.32 | $2.80 | $3.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.17 / $3.03 / $5.00
| Professional | | $2.17 | $3.03 | $5.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.43 / $5.65 / $12.56
| Facility | | $3.43 | $5.65 | $12.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $2.06 / $2.06
| Professional | | $2.06 | $2.06 | $2.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.25 / $3.25 / $3.25
| Professional | | $3.25 | $3.25 | $3.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.33 / $4.33 / $4.33
| Facility | | $4.33 | $4.33 | $4.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.76 / $6.76 / $6.76
| Facility | | $6.76 | $6.76 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.77 / $1.77 / $1.77
| Professional | | $1.77 | $1.77 | $1.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $90.00 / $90.00
| Facility | | $75.00 | $90.00 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.47 / $44.16 / $45.93
| Professional | | $32.47 | $44.16 | $45.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.51 / $4.33 / $8.67
| Facility | | $1.51 | $4.33 | $8.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.65 / $3.98 / $4.33
| Professional | | $2.65 | $3.98 | $4.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.33 / $5.90 / $9.74
| Professional | | $4.33 | $5.90 | $9.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.37 / $4.32 / $8.67
| Facility | | $1.37 | $4.32 | $8.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.77 / $1.77 / $4.12
| Professional | | $1.77 | $1.77 | $4.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.53 / $2.00 / $3.05
| Professional | | $1.53 | $2.00 | $3.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $4.33 / $5.85
| Professional | | $2.06 | $4.33 | $5.85 |