- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.84 / $3.26 / $6.18
| Facility | | $2.84 | $3.26 | $6.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.84 / $3.70 / $6.18
| Professional | | $2.84 | $3.70 | $6.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.20 / $4.22 / $8.52
| Professional | | $3.20 | $4.22 | $8.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.05 / $5.44 / $5.44
| Facility | | $5.05 | $5.44 | $5.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.44 / $5.44 / $5.44
| Professional | | $5.44 | $5.44 | $5.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.93 / $3.93 / $4.16
| Facility | | $3.93 | $3.93 | $4.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.34 / $3.34 / $4.62
| Professional | | $3.34 | $3.34 | $4.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.53 / $14.69 / $332.00
| Facility | | $6.53 | $14.69 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.85 / $5.05 / $11.95
| Professional | | $3.85 | $5.05 | $11.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.05 / $5.05 / $5.05
| Facility | | $5.05 | $5.05 | $5.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $4.30 / $5.44
| Professional | | $4.05 | $4.30 | $5.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.29 / $5.29 / $5.29
| Professional | | $5.29 | $5.29 | $5.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.93 / $3.93 / $555.00
| Facility | | $3.93 | $3.93 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.34 / $4.00 / $9.38
| Professional | | $3.34 | $4.00 | $9.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.17 / $3.31 / $5.88
| Professional | | $2.17 | $3.31 | $5.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.05 / $4.05 / $4.05
| Facility | | $4.05 | $4.05 | $4.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $4.05 / $5.05
| Professional | | $4.05 | $4.05 | $5.05 |