- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.76 / $5.30 / $9.05
| Facility | | $3.76 | $5.30 | $9.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.76 / $5.30 / $8.18
| Professional | | $3.76 | $5.30 | $8.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.84 / $3.84 / $13.88
| Professional | | $3.84 | $3.84 | $13.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.70 / $7.20 / $7.20
| Facility | | $6.70 | $7.20 | $7.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.20 / $7.20 / $7.20
| Professional | | $7.20 | $7.20 | $7.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.13 / $10.13 / $10.13
| Facility | | $10.13 | $10.13 | $10.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.52 / $3.87 / $3.87
| Professional | | $3.52 | $3.87 | $3.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.64 / $15.81 / $332.00
| Facility | | $8.64 | $15.81 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.64 / $11.66 / $18.75
| Professional | | $8.64 | $11.66 | $18.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.43 / $4.43 / $5.00
| Facility | | $4.43 | $4.43 | $5.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.43 / $5.00 / $5.31
| Professional | | $4.43 | $5.00 | $5.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.13 / $10.13 / $597.00
| Facility | | $10.13 | $10.13 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.52 / $3.87 / $12.86
| Professional | | $3.52 | $3.87 | $12.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.88 / $5.18 / $9.71
| Professional | | $2.88 | $5.18 | $9.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.00 / $5.00 / $6.19
| Facility | | $5.00 | $5.00 | $6.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.43 / $5.00 / $5.31
| Professional | | $4.43 | $5.00 | $5.31 |