- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.87 / $3.21 / $6.23
| Facility | | $2.87 | $3.21 | $6.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $3.21 / $6.23
| Professional | | $2.73 | $3.21 | $6.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.80 / $2.80 / $9.08
| Professional | | $2.80 | $2.80 | $9.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.11 / $5.49 / $5.49
| Facility | | $5.11 | $5.49 | $5.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.49 / $5.49 / $5.49
| Professional | | $5.49 | $5.49 | $5.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.96 / $3.96 / $3.96
| Facility | | $3.96 | $3.96 | $3.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.37 / $3.37 / $4.88
| Professional | | $3.37 | $3.37 | $4.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.58 / $14.81 / $332.00
| Facility | | $6.58 | $14.81 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.40 / $4.94 / $12.04
| Professional | | $3.40 | $4.94 | $12.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.88 / $1.88 / $1.88
| Facility | | $1.88 | $1.88 | $1.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.88 / $4.75 / $4.75
| Professional | | $1.88 | $4.75 | $4.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.96 / $3.96 / $555.00
| Facility | | $3.96 | $3.96 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.37 / $3.96 / $9.38
| Professional | | $3.37 | $3.96 | $9.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $3.41 / $6.03
| Professional | | $2.19 | $3.41 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.70 / $4.75 / $4.75
| Facility | | $4.70 | $4.75 | $4.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.88 / $4.75 / $4.75
| Professional | | $1.88 | $4.75 | $4.75 |