- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.98 / $4.47 / $8.66
| Facility | | $3.98 | $4.47 | $8.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.50 / $4.47 / $8.66
| Professional | | $2.50 | $4.47 | $8.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.90 / $3.90 / $12.62
| Professional | | $3.90 | $3.90 | $12.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.10 / $7.63 / $7.63
| Facility | | $7.10 | $7.63 | $7.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.63 / $7.63 / $7.63
| Professional | | $7.63 | $7.63 | $7.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.50 / $5.50 / $6.62
| Facility | | $5.50 | $5.50 | $6.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.68 / $4.68 / $6.62
| Professional | | $4.68 | $4.68 | $6.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.16 / $20.61 / $332.00
| Facility | | $9.16 | $20.61 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.14 / $6.87 / $16.76
| Professional | | $5.14 | $6.87 | $16.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.42 / $6.42 / $6.42
| Facility | | $6.42 | $6.42 | $6.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.50 / $5.85 / $7.63
| Professional | | $5.50 | $5.85 | $7.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.08 / $5.08 / $5.08
| Professional | | $5.08 | $5.08 | $5.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.50 / $5.50 / $555.00
| Facility | | $5.50 | $5.50 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.68 / $5.50 / $13.13
| Professional | | $4.68 | $5.50 | $13.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.04 / $4.79 / $7.89
| Professional | | $3.04 | $4.79 | $7.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.24 / $5.50 / $5.50
| Facility | | $5.24 | $5.50 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.50 / $5.50 / $6.42
| Professional | | $5.50 | $5.50 | $6.42 |