- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.57 / $2.22 / $3.80
| Facility | | $1.57 | $2.22 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.57 / $2.22 / $3.42
| Professional | | $1.57 | $2.22 | $3.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.60 / $1.62 / $5.17
| Professional | | $1.60 | $1.62 | $5.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $3.02 / $3.02
| Facility | | $2.81 | $3.02 | $3.02 |
- 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
- $4.25 / $4.25 / $4.25
| Facility | | $4.25 | $4.25 | $4.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $1.85 / $1.85
| Professional | | $1.85 | $1.85 | $1.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.62 / $6.62 / $332.00
| Facility | | $3.62 | $6.62 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $4.88 / $7.86
| Professional | | $2.09 | $4.88 | $7.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.09 / $1.09 / $2.08
| Facility | | $1.09 | $1.09 | $2.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.09 / $2.08 / $2.21
| Professional | | $1.09 | $2.08 | $2.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.25 / $4.25 / $597.00
| Facility | | $4.25 | $4.25 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $1.85 / $6.20
| Professional | | $1.85 | $1.85 | $6.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.20 / $2.17 / $4.05
| Professional | | $1.20 | $2.17 | $4.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.08 / $2.08 / $2.58
| Facility | | $2.08 | $2.08 | $2.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.09 / $2.08 / $2.21
| Professional | | $1.09 | $2.08 | $2.21 |