- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.43 / $12.14 / $13.01
| Facility | | $3.43 | $12.14 | $13.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.66 / $3.44 / $3.86
| Professional | | $2.66 | $3.44 | $3.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.59 / $21.85 / $45.94
| Facility | | $9.59 | $21.85 | $45.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.59 / $9.59 / $9.59
| Professional | | $9.59 | $9.59 | $9.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.57 / $3.57 / $3.57
| Facility | | $3.57 | $3.57 | $3.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.57 / $3.57 / $3.57
| Professional | | $3.57 | $3.57 | $3.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $90.00 / $90.00
| Facility | | $80.00 | $90.00 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.20 / $28.20 / $36.75
| Professional | | $28.20 | $28.20 | $36.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.46 / $5.11 / $9.82
| Facility | | $3.46 | $5.11 | $9.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.97 / $3.97 / $3.97
| Professional | | $3.97 | $3.97 | $3.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.87 / $8.80 / $9.40
| Professional | | $5.87 | $8.80 | $9.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.46 / $3.57 / $7.57
| Facility | | $3.46 | $3.57 | $7.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.57 / $3.57 / $3.57
| Professional | | $3.57 | $3.57 | $3.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.14 / $6.95 / $6.95
| Facility | | $5.14 | $6.95 | $6.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $2.81 / $9.59
| Professional | | $2.35 | $2.81 | $9.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.19 / $9.59 / $12.95
| Professional | | $4.19 | $9.59 | $12.95 |