- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.52 / $5.72 / $5.97
| Facility | | $2.52 | $5.72 | $5.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.91 / $2.52 / $5.97
| Professional | | $1.91 | $2.52 | $5.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.90 / $80.00 / $80.00
| Facility | | $3.90 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.91 / $3.78 / $21.36
| Professional | | $2.91 | $3.78 | $21.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.68 / $2.68 / $3.31
| Facility | | $2.68 | $2.68 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $2.27 / $3.31
| Professional | | $2.27 | $2.27 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.48 / $4.45 / $7.09
| Facility | | $2.48 | $4.45 | $7.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $4.58 / $8.07
| Professional | | $2.52 | $4.58 | $8.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.45 / $4.45 / $75.00
| Professional | | $4.45 | $4.45 | $75.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.01 / $3.70 / $4.45
| Facility | | $3.01 | $3.70 | $4.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.31 / $4.01 / $4.73
| Professional | | $3.31 | $4.01 | $4.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.70 / $3.90 / $7.21
| Facility | | $3.70 | $3.90 | $7.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.70 / $4.03 / $6.40
| Professional | | $3.70 | $4.03 | $6.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.54 / $3.78 / $4.67
| Professional | | $3.54 | $3.78 | $4.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $2.04 / $3.60
| Professional | | $1.78 | $2.04 | $3.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.57 / $1.57 / $2.25
| Professional | | $1.57 | $1.57 | $2.25 |