- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.71 / $8.42 / $8.78
| Facility | | $3.71 | $8.42 | $8.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.84 / $3.71 / $8.90
| Professional | | $1.84 | $3.71 | $8.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.74 / $80.00 / $80.00
| Facility | | $5.74 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.73 / $5.79 / $32.61
| Professional | | $4.73 | $5.79 | $32.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.94 / $3.94 / $3.94
| Facility | | $3.94 | $3.94 | $3.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.35 / $3.35 / $4.86
| Professional | | $3.35 | $3.35 | $4.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.64 / $6.55 / $11.03
| Facility | | $3.64 | $6.55 | $11.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $6.55 / $11.58
| Professional | | $3.72 | $6.55 | $11.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.55 / $6.55 / $75.00
| Professional | | $6.55 | $6.55 | $75.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.19 / $6.40 / $6.55
| Facility | | $5.19 | $6.40 | $6.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.72 / $6.55 / $6.55
| Professional | | $5.72 | $6.55 | $6.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.44 / $5.74 / $10.61
| Facility | | $5.44 | $5.74 | $10.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.44 / $6.21 / $9.42
| Professional | | $5.44 | $6.21 | $9.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.20 / $5.57 / $7.21
| Professional | | $5.20 | $5.57 | $7.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $2.78 / $5.30
| Professional | | $2.57 | $2.78 | $5.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.83 / $3.83 / $4.18
| Professional | | $3.83 | $3.83 | $4.18 |