- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.01 / $1.11 / $10.90
| Facility | | $1.01 | $1.11 | $10.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.04 / $1.65 / $10.55
| Professional | | $1.04 | $1.65 | $10.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.84 / $2.84 / $3.78
| Professional | | $2.84 | $2.84 | $3.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.36 / $1.64 / $4.34
| Facility | | $1.36 | $1.64 | $4.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.89 / $1.89 / $3.52
| Professional | | $1.89 | $1.89 | $3.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.99 / $5.18 / $8.00
| Facility | | $3.99 | $5.18 | $8.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $8.11 / $14.21
| Professional | | $2.04 | $8.11 | $14.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.27 / $2.27 / $3.00
| Facility | | $2.27 | $2.27 | $3.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.93 / $1.93 / $2.40
| Professional | | $1.93 | $1.93 | $2.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.39 / $3.78 / $4.16
| Professional | | $3.39 | $3.78 | $4.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $2.65 / $5.86
| Professional | | $2.27 | $2.65 | $5.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $80.00 / $80.00
| Facility | | $75.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.82 / $18.82 / $28.35
| Professional | | $18.82 | $18.82 | $28.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.04 / $3.35 / $3.78
| Facility | | $1.04 | $3.35 | $3.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.93 / $2.27 / $3.45
| Professional | | $1.93 | $2.27 | $3.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.12 / $7.12 / $7.12
| Professional | | $7.12 | $7.12 | $7.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $4.43 / $5.76
| Professional | | $3.02 | $4.43 | $5.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.45 / $1.60 / $3.68
| Professional | | $1.45 | $1.60 | $3.68 |