- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $8.13 / $13.49
| Facility | | $5.89 | $8.13 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.98 / $21.88
| Professional | | $3.02 | $3.98 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.27 / $5.01 / $9.33
| Facility | | $4.27 | $5.01 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.37 / $4.57 / $32.36
| Professional | | $4.37 | $4.57 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.72 / $23.44 / $26.92
| Facility | | $10.72 | $23.44 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.27 / $5.62 / $22.39
| Professional | | $4.27 | $5.62 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.72 / $3.72 / $3.98
| Facility | | $3.72 | $3.72 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $3.98 / $3.98
| Professional | | $3.98 | $3.98 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $4.37 / $14.13
| Professional | | $3.55 | $4.37 | $14.13 |
- 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
- $5.50 / $5.50 / $5.50
| Professional | | $5.50 | $5.50 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.62 / $9.33 / $15.14
| Facility | | $5.62 | $9.33 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $6.03 / $13.18
| Professional | | $6.03 | $6.03 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $26.30 / $26.30
| Professional | | $26.30 | $26.30 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.90 / $6.61 / $10.23
| Professional | | $4.90 | $6.61 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.48 / $52.48 / $52.48
| Facility | | $52.48 | $52.48 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $3.98 / $10.72
| Professional | | $3.98 | $3.98 | $10.72 |