- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.31 / $8.03 / $34.26
| Facility | | $2.31 | $8.03 | $34.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.20 / $2.29 / $11.96
| Professional | | $2.20 | $2.29 | $11.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.21 / $2.99
| Professional | | $2.04 | $2.21 | $2.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.41 / $1.41 / $1.48
| Facility | | $1.41 | $1.41 | $1.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $1.41 / $1.41
| Professional | | $1.41 | $1.41 | $1.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.06 / $2.08 / $2.21
| Facility | | $2.06 | $2.08 | $2.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.21 / $2.21 / $2.21
| Professional | | $2.21 | $2.21 | $2.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.08 / $3.12 / $332.00
| Facility | | $2.08 | $3.12 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $2.40 / $3.83
| Professional | | $2.40 | $2.40 | $3.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.21 / $2.21 / $2.29
| Facility | | $2.21 | $2.21 | $2.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.21 / $2.21 / $2.29
| Professional | | $2.21 | $2.21 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.31 / $3.28 / $4.40
| Facility | | $1.31 | $3.28 | $4.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.06 / $2.08 / $555.00
| Facility | | $2.06 | $2.08 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.21 / $3.90
| Professional | | $2.00 | $2.21 | $3.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.21 / $2.21 / $3.46
| Professional | | $2.21 | $2.21 | $3.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.29 / $2.29 / $2.29
| Facility | | $2.29 | $2.29 | $2.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.93 / $2.21 / $2.29
| Professional | | $0.93 | $2.21 | $2.29 |