- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.65 / $4.09 / $7.94
| Facility | | $3.65 | $4.09 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.65 / $4.33 / $7.94
| Professional | | $3.65 | $4.33 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.03 / $4.41 / $10.73
| Professional | | $4.03 | $4.41 | $10.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.50 / $6.99 / $6.99
| Facility | | $6.50 | $6.99 | $6.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.99 / $6.99 / $6.99
| Professional | | $6.99 | $6.99 | $6.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.04 / $5.04 / $5.34
| Facility | | $5.04 | $5.04 | $5.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.28 / $4.28 / $5.93
| Professional | | $4.28 | $4.28 | $5.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.40 / $18.89 / $332.00
| Facility | | $8.40 | $18.89 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.80 / $6.05 / $14.87
| Professional | | $4.80 | $6.05 | $14.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.45 / $4.45 / $4.45
| Facility | | $4.45 | $4.45 | $4.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.45 / $6.07 / $6.07
| Professional | | $4.45 | $6.07 | $6.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.86 / $6.86 / $6.86
| Professional | | $6.86 | $6.86 | $6.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.04 / $5.04 / $555.00
| Facility | | $5.04 | $5.04 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.04 / $4.28 / $12.19
| Professional | | $4.04 | $4.28 | $12.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.79 / $4.23 / $7.08
| Professional | | $2.79 | $4.23 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.00 / $6.07 / $6.07
| Facility | | $5.00 | $6.07 | $6.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.45 / $6.07 / $6.07
| Professional | | $4.45 | $6.07 | $6.07 |