- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.06 / $2.29 / $4.48
| Facility | | $2.06 | $2.29 | $4.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.29 / $2.29 / $4.48
| Professional | | $1.29 | $2.29 | $4.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.01 / $3.01 / $7.58
| Professional | | $3.01 | $3.01 | $7.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.67 / $3.95 / $3.95
| Facility | | $3.67 | $3.95 | $3.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.95 / $3.95 / $3.95
| Professional | | $3.95 | $3.95 | $3.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.69 / $2.85 / $2.85
| Facility | | $2.69 | $2.85 | $2.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.42 / $2.42 / $3.35
| Professional | | $2.42 | $2.42 | $3.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.74 / $10.67 / $332.00
| Facility | | $4.74 | $10.67 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.66 / $3.56 / $8.67
| Professional | | $2.66 | $3.56 | $8.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.32 / $3.32 / $3.32
| Facility | | $3.32 | $3.32 | $3.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.84 / $3.00 / $3.95
| Professional | | $2.84 | $3.00 | $3.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.97 / $2.97 / $2.97
| Professional | | $2.97 | $2.97 | $2.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.69 / $2.85 / $555.00
| Facility | | $2.69 | $2.85 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.42 / $2.69 / $7.35
| Professional | | $2.42 | $2.69 | $7.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.58 / $2.36 / $4.33
| Professional | | $1.58 | $2.36 | $4.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.84 / $2.84 / $3.37
| Facility | | $2.84 | $2.84 | $3.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.84 / $2.84 / $3.32
| Professional | | $2.84 | $2.84 | $3.32 |