- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.98 / $5.61 / $9.58
| Facility | | $3.98 | $5.61 | $9.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $5.61 / $8.65
| Professional | | $3.98 | $5.61 | $8.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $4.45 / $13.06
| Professional | | $4.05 | $4.45 | $13.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.09 / $7.62 / $7.62
| Facility | | $7.09 | $7.62 | $7.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.62 / $7.62 / $7.62
| Professional | | $7.62 | $7.62 | $7.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.73 / $10.73 / $10.73
| Facility | | $10.73 | $10.73 | $10.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.67 / $4.67 / $4.67
| Professional | | $4.67 | $4.67 | $4.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.15 / $16.73 / $332.00
| Facility | | $9.15 | $16.73 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $12.35 / $19.86
| Professional | | $5.75 | $12.35 | $19.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.28 / $5.75 / $5.75
| Facility | | $5.28 | $5.75 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.28 / $5.62 / $5.75
| Professional | | $5.28 | $5.62 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.73 / $10.73 / $597.00
| Facility | | $10.73 | $10.73 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.67 / $4.67 / $15.66
| Professional | | $4.67 | $4.67 | $15.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.04 / $5.43 / $10.09
| Professional | | $3.04 | $5.43 | $10.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.28 / $5.28 / $6.54
| Facility | | $5.28 | $5.28 | $6.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.28 / $5.62 / $5.75
| Professional | | $5.28 | $5.62 | $5.75 |