- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.84 / $6.45 / $6.73
| Facility | | $2.84 | $6.45 | $6.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $2.84 / $6.79
| Professional | | $1.41 | $2.84 | $6.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.38 / $80.00 / $80.00
| Facility | | $4.38 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.50 / $4.42 / $24.90
| Professional | | $3.50 | $4.42 | $24.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.01 / $3.01 / $3.72
| Facility | | $3.01 | $3.01 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $2.56 / $3.72
| Professional | | $2.56 | $2.56 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.10 / $5.00 / $8.80
| Facility | | $3.10 | $5.00 | $8.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.10 / $5.11 / $9.13
| Professional | | $3.10 | $5.11 | $9.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $5.00 / $75.00
| Professional | | $5.00 | $5.00 | $75.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.98 / $4.88 / $5.00
| Facility | | $3.98 | $4.88 | $5.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.38 / $5.00 / $5.00
| Professional | | $4.38 | $5.00 | $5.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.15 / $4.38 / $8.09
| Facility | | $4.15 | $4.38 | $8.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.15 / $4.73 / $7.19
| Professional | | $4.15 | $4.73 | $7.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $4.25 / $5.50
| Professional | | $3.98 | $4.25 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.48 / $4.05
| Professional | | $2.00 | $2.48 | $4.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.25 / $3.25 / $3.25
| Professional | | $3.25 | $3.25 | $3.25 |