- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.46 / $1.46 / $388.00
| Facility | | $1.46 | $1.46 | $388.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $1.42 / $5.21
| Professional | | $1.41 | $1.42 | $5.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $1.42 / $2.13
| Professional | | $1.42 | $1.42 | $2.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.95 / $2.25 / $2.27
| Facility | | $1.95 | $2.25 | $2.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.41 / $3.60 / $5.11
| Facility | | $1.41 | $3.60 | $5.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $2.60 / $2.95
| Professional | | $1.41 | $2.60 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.32 / $1.42 / $1.47
| Facility | | $1.32 | $1.42 | $1.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.60 / $1.60 / $1.60
| Professional | | $1.60 | $1.60 | $1.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.32 / $1.42 / $8.69
| Facility | | $1.32 | $1.42 | $8.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $1.42 / $3.86
| Professional | | $1.42 | $1.42 | $3.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $65.00 / $85.00
| Professional | | $1.41 | $65.00 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.32 / $1.42 / $2.86
| Facility | | $1.32 | $1.42 | $2.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.60 / $1.60 / $1.60
| Professional | | $1.60 | $1.60 | $1.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $1.80 / $5.40
| Professional | | $1.41 | $1.80 | $5.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $2.69 / $7.42
| Professional | | $1.41 | $2.69 | $7.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.87 / $1.99 / $2.17
| Professional | | $1.87 | $1.99 | $2.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $1.42 / $2.13
| Professional | | $1.42 | $1.42 | $2.13 |