- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.74 / $1.96 / $3.79
| Facility | | $1.74 | $1.96 | $3.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.10 / $1.96 / $3.79
| Professional | | $1.10 | $1.96 | $3.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.30 / $5.25 / $7.78
| Professional | | $3.30 | $5.25 | $7.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.11 / $3.34 / $3.34
| Facility | | $3.11 | $3.34 | $3.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.34 / $3.34 / $3.34
| Professional | | $3.34 | $3.34 | $3.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $2.41
| Facility | | $2.41 | $2.41 | $2.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.04 / $2.97
| Professional | | $2.04 | $2.04 | $2.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.01 / $9.02 / $332.00
| Facility | | $4.01 | $9.02 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $3.19 / $7.34
| Professional | | $2.25 | $3.19 | $7.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $2.81 / $2.81
| Facility | | $2.81 | $2.81 | $2.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.42 / $2.56 / $3.34
| Professional | | $2.42 | $2.56 | $3.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $555.00
| Facility | | $2.41 | $2.41 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.41 / $5.63
| Professional | | $2.04 | $2.41 | $5.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.33 / $2.29 / $3.66
| Professional | | $1.33 | $2.29 | $3.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.42 / $2.42 / $2.87
| Facility | | $2.42 | $2.42 | $2.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.42 / $2.42 / $2.81
| Professional | | $2.42 | $2.42 | $2.81 |