- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $1.00 / $4.37
| Facility | | $1.00 | $1.00 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $1.00 / $2.00
| Professional | | $1.00 | $1.00 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.63 / $2.63 / $4.37
| Facility | | $2.63 | $2.63 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $2.45 / $2.82
| Professional | | $2.45 | $2.45 | $2.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.24 / $8.51 / $13.49
| Facility | | $7.24 | $8.51 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.32 / $3.72 / $5.01
| Professional | | $1.32 | $3.72 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.48 / $1.91 / $2.75
| Facility | | $1.48 | $1.91 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $3.16 / $3.80
| Professional | | $2.40 | $3.16 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.48 / $2.04 / $5.25
| Facility | | $1.48 | $2.04 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.12 / $1.32 / $12.88
| Professional | | $1.12 | $1.32 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.32 / $33.11 / $70.79
| Professional | | $1.32 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.63 / $4.07 / $7.41
| Professional | | $2.63 | $4.07 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $5.25 / $79.43
| Facility | | $5.25 | $5.25 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.32 / $3.98 / $12.88
| Professional | | $1.32 | $3.98 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.63 / $2.63 / $2.63
| Professional | | $2.63 | $2.63 | $2.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.63 / $2.63 / $2.63
| Professional | | $2.63 | $2.63 | $2.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.87 / $1.32 / $2.09
| Professional | | $0.87 | $1.32 | $2.09 |