- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.86 / $2.17 / $4.04
| Facility | | $1.86 | $2.17 | $4.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $2.18 / $4.04
| Professional | | $1.86 | $2.18 | $4.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.13 / $2.87 / $5.64
| Professional | | $2.13 | $2.87 | $5.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $3.56 / $3.56
| Facility | | $3.31 | $3.56 | $3.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.56 / $3.56 / $3.56
| Professional | | $3.56 | $3.56 | $3.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.67 / $2.67 / $3.30
| Facility | | $2.67 | $2.67 | $3.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $2.27 / $3.41
| Professional | | $2.27 | $2.27 | $3.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.28 / $9.63 / $332.00
| Facility | | $4.28 | $9.63 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.44 / $3.08 / $7.58
| Professional | | $2.44 | $3.08 | $7.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.23 / $3.23 / $3.23
| Facility | | $3.23 | $3.23 | $3.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.08 / $3.08 / $3.56
| Professional | | $3.08 | $3.08 | $3.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.97 / $2.97 / $2.97
| Professional | | $2.97 | $2.97 | $2.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.67 / $2.67 / $555.00
| Facility | | $2.67 | $2.67 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $2.62 / $6.38
| Professional | | $2.27 | $2.62 | $6.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $2.13 / $3.68
| Professional | | $1.42 | $2.13 | $3.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.08 / $3.08 / $3.35
| Facility | | $3.08 | $3.08 | $3.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.08 / $3.08 / $3.23
| Professional | | $3.08 | $3.08 | $3.23 |