- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.87 / $6.08 / $13.67
| Professional | | $5.87 | $6.08 | $13.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.30 / $80.00 / $85.00
| Facility | | $10.30 | $80.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.08 / $9.77 / $13.19
| Professional | | $1.08 | $9.77 | $13.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.00 / $8.00 / $8.00
| Facility | | $8.00 | $8.00 | $8.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.80 / $8.00 / $10.49
| Professional | | $6.80 | $8.00 | $10.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.44 / $11.44 / $11.44
| Facility | | $11.44 | $11.44 | $11.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.44 / $11.44 / $11.44
| Professional | | $11.44 | $11.44 | $11.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.09 / $10.11 / $11.12
| Professional | | $9.09 | $10.11 | $11.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.44 / $12.15 / $13.19
| Facility | | $11.44 | $12.15 | $13.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.48 / $11.44 / $13.19
| Professional | | $10.48 | $11.44 | $13.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.03 / $10.30 / $10.30
| Facility | | $1.03 | $10.30 | $10.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $10.51 / $12.78
| Professional | | $2.06 | $10.51 | $12.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.11 / $11.11 / $11.11
| Facility | | $11.11 | $11.11 | $11.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.89 / $0.89 / $1.08
| Professional | | $0.89 | $0.89 | $1.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.69 / $5.84 / $11.23
| Professional | | $5.69 | $5.84 | $11.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.24 / $8.24 / $9.77
| Professional | | $8.24 | $8.24 | $9.77 |