- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.82 / $3.02 / $3.02
| Facility | | $2.82 | $3.02 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.02 / $5.01
| Professional | | $2.00 | $3.02 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.95 / $2.95 / $3.55
| Facility | | $2.95 | $2.95 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.02 / $3.02
| Professional | | $3.02 | $3.02 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.75 / $5.75 / $79.43
| Facility | | $5.75 | $5.75 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.89 / $3.98 / $3.98
| Facility | | $3.89 | $3.98 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.39 / $3.39 / $3.98
| Professional | | $3.39 | $3.39 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $85.11 / $85.11
| Facility | | $79.43 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $48.98 / $48.98
| Professional | | $31.62 | $48.98 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.02 / $5.13 / $8.32
| Facility | | $3.02 | $5.13 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.02 / $5.01
| Professional | | $2.00 | $3.02 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $3.55 / $4.07
| Professional | | $3.55 | $3.55 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.09 / $4.90 / $8.51
| Facility | | $3.09 | $4.90 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.39 / $3.39 / $4.37
| Professional | | $3.39 | $3.39 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.91 / $2.57 / $4.17
| Facility | | $1.91 | $2.57 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $3.02 / $3.98
| Professional | | $2.34 | $3.02 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $5.75 / $5.75
| Professional | | $5.75 | $5.75 | $5.75 |