- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.97 / $2.36 / $9.75
| Facility | | $1.97 | $2.36 | $9.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.98 / $2.79 / $4.30
| Professional | | $1.98 | $2.79 | $4.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.02 / $2.02 / $7.29
| Professional | | $2.02 | $2.02 | $7.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.52 / $3.79 / $3.79
| Facility | | $3.52 | $3.79 | $3.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.79 / $3.79 / $3.79
| Professional | | $3.79 | $3.79 | $3.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.33 / $5.33 / $5.33
| Facility | | $5.33 | $5.33 | $5.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.31 / $2.31 / $2.31
| Professional | | $2.31 | $2.31 | $2.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.55 / $8.33 / $332.00
| Facility | | $4.55 | $8.33 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.55 / $6.14 / $9.86
| Professional | | $4.55 | $6.14 | $9.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.57 / $2.57 / $2.63
| Facility | | $2.57 | $2.57 | $2.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $2.63 / $2.79
| Professional | | $2.57 | $2.63 | $2.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.33 / $5.33 / $597.00
| Facility | | $5.33 | $5.33 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.31 / $2.31 / $7.79
| Professional | | $2.31 | $2.31 | $7.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.51 / $2.60 / $5.09
| Professional | | $1.51 | $2.60 | $5.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.63 / $2.63 / $3.25
| Facility | | $2.63 | $2.63 | $3.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $2.63 / $2.79
| Professional | | $2.57 | $2.63 | $2.79 |