- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.85 / $3.42 / $38.78
| Facility | | $1.85 | $3.42 | $38.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $2.60 / $4.01
| Professional | | $1.85 | $2.60 | $4.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.88 / $1.88 / $6.80
| Professional | | $1.88 | $1.88 | $6.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.29 / $3.54 / $3.54
| Facility | | $3.29 | $3.54 | $3.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.54 / $3.54 / $3.54
| Professional | | $3.54 | $3.54 | $3.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.98 / $4.98 / $4.98
| Facility | | $4.98 | $4.98 | $4.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.17 / $2.17 / $2.17
| Professional | | $2.17 | $2.17 | $2.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.25 / $7.78 / $332.00
| Facility | | $4.25 | $7.78 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.25 / $5.74 / $9.22
| Professional | | $4.25 | $5.74 | $9.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.73 / $1.73 / $2.44
| Facility | | $1.73 | $1.73 | $2.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.73 / $2.44 / $2.61
| Professional | | $1.73 | $2.44 | $2.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.98 / $4.98 / $597.00
| Facility | | $4.98 | $4.98 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.17 / $2.17 / $7.27
| Professional | | $2.17 | $2.17 | $7.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $2.54 / $5.35
| Professional | | $1.41 | $2.54 | $5.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.44 / $2.44 / $3.03
| Facility | | $2.44 | $2.44 | $3.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.73 / $2.44 / $2.61
| Professional | | $1.73 | $2.44 | $2.61 |