- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.27 / $5.15 / $5.38
| Facility | | $2.27 | $5.15 | $5.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.72 / $2.27 / $5.44
| Professional | | $1.72 | $2.27 | $5.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.51 / $80.00 / $80.00
| Facility | | $3.51 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.07 / $3.81 / $19.97
| Professional | | $3.07 | $3.81 | $19.97 |
- 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
- $2.27 / $4.01 / $7.09
| Facility | | $2.27 | $4.01 | $7.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $4.09 / $7.44
| Professional | | $2.48 | $4.09 | $7.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.01 / $4.01 / $75.00
| Professional | | $4.01 | $4.01 | $75.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.18 / $3.92 / $4.01
| Facility | | $3.18 | $3.92 | $4.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.50 / $4.01 / $4.01
| Professional | | $3.50 | $4.01 | $4.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.33 / $3.51 / $6.50
| Facility | | $3.33 | $3.51 | $6.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.33 / $3.80 / $5.77
| Professional | | $3.33 | $3.80 | $5.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.18 / $3.41 / $4.41
| Professional | | $3.18 | $3.41 | $4.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.58 / $1.70 / $3.25
| Professional | | $1.58 | $1.70 | $3.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $2.35 / $5.25
| Professional | | $2.35 | $2.35 | $5.25 |