- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.31 / $6.69 / $11.79
| Facility | | $5.31 | $6.69 | $11.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.57 / $5.62 / $7.64
| Professional | | $5.57 | $5.62 | $7.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.46 / $4.46 / $5.57
| Facility | | $4.46 | $4.46 | $5.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.57 / $5.98 / $5.98
| Professional | | $5.57 | $5.98 | $5.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.05 / $5.05 / $5.31
| Facility | | $5.05 | $5.05 | $5.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $5.05 / $5.05
| Professional | | $5.05 | $5.05 | $5.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $5.25 / $5.57
| Facility | | $5.25 | $5.25 | $5.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.57 / $5.57 / $5.57
| Professional | | $5.57 | $5.57 | $5.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $7.88 / $332.00
| Facility | | $5.25 | $7.88 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.78 / $5.78 / $7.19
| Professional | | $5.78 | $5.78 | $7.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.57 / $5.57 / $5.68
| Facility | | $5.57 | $5.57 | $5.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.57 / $5.57 / $5.68
| Professional | | $5.57 | $5.57 | $5.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $5.25 / $555.00
| Facility | | $5.25 | $5.25 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.57 / $5.57 / $7.53
| Professional | | $5.57 | $5.57 | $7.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.57 / $5.57 / $5.57
| Facility | | $5.57 | $5.57 | $5.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.57 / $5.57 / $8.05
| Professional | | $5.57 | $5.57 | $8.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.68 / $5.68 / $5.68
| Facility | | $5.68 | $5.68 | $5.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.72 / $5.57 / $5.68
| Professional | | $4.72 | $5.57 | $5.68 |