- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.15 / $2.41 / $4.67
| Facility | | $2.15 | $2.41 | $4.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.72 / $2.41 / $4.67
| Professional | | $1.72 | $2.41 | $4.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.38 / $3.18 / $6.34
| Professional | | $2.38 | $3.18 | $6.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.82 / $4.11 / $4.11
| Facility | | $3.82 | $4.11 | $4.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.11 / $4.11 / $4.11
| Professional | | $4.11 | $4.11 | $4.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.97 / $2.97 / $3.14
| Facility | | $2.97 | $2.97 | $3.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $2.52 / $3.49
| Professional | | $2.52 | $2.52 | $3.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.94 / $11.12 / $332.00
| Facility | | $4.94 | $11.12 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.80 / $3.56 / $8.74
| Professional | | $2.80 | $3.56 | $8.74 |
- 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 / $3.56 / $4.08
| Professional | | $3.40 | $3.56 | $4.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.97 / $2.97 / $555.00
| Facility | | $2.97 | $2.97 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $2.89 / $7.03
| Professional | | $2.52 | $2.89 | $7.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.64 / $2.46 / $4.20
| Professional | | $1.64 | $2.46 | $4.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.10 / $3.56 / $3.56
| Facility | | $3.10 | $3.56 | $3.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.40 / $3.56 / $3.56
| Professional | | $3.40 | $3.56 | $3.56 |