- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.21 / $4.73 / $9.15
| Facility | | $4.21 | $4.73 | $9.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.64 / $4.73 / $9.15
| Professional | | $2.64 | $4.73 | $9.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.12 / $4.12 / $13.34
| Professional | | $4.12 | $4.12 | $13.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.50 / $8.06 / $8.06
| Facility | | $7.50 | $8.06 | $8.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.06 / $8.06 / $8.06
| Professional | | $8.06 | $8.06 | $8.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.81 / $5.81 / $7.17
| Facility | | $5.81 | $5.81 | $7.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.94 / $4.94 / $7.17
| Professional | | $4.94 | $4.94 | $7.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.68 / $21.78 / $332.00
| Facility | | $9.68 | $21.78 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $7.26 / $17.71
| Professional | | $5.00 | $7.26 | $17.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.40 / $3.40 / $3.40
| Facility | | $3.40 | $3.40 | $3.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.40 / $5.60 / $6.94
| Professional | | $3.40 | $5.60 | $6.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.81 / $5.81 / $555.00
| Facility | | $5.81 | $5.81 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.94 / $5.81 / $14.06
| Professional | | $4.94 | $5.81 | $14.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.22 / $5.09 / $8.84
| Professional | | $3.22 | $5.09 | $8.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.54 / $5.60 / $5.60
| Facility | | $5.54 | $5.60 | $5.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.40 / $5.60 / $5.95
| Professional | | $3.40 | $5.60 | $5.95 |