- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.25 / $3.98 / $6.52
| Facility | | $3.25 | $3.98 | $6.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.25 / $3.25 / $4.40
| Professional | | $3.25 | $3.25 | $4.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.60 / $2.60 / $3.25
| Facility | | $2.60 | $2.60 | $3.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.06 / $3.25 / $3.25
| Professional | | $3.06 | $3.25 | $3.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.00 / $3.00 / $3.15
| Facility | | $3.00 | $3.00 | $3.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $3.00 / $3.00
| Professional | | $3.00 | $3.00 | $3.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.06 / $3.06 / $3.24
| Facility | | $3.06 | $3.06 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.24 / $3.24 / $3.24
| Professional | | $3.24 | $3.24 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.06 / $4.59 / $332.00
| Facility | | $3.06 | $4.59 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.52 / $3.52 / $4.59
| Professional | | $3.52 | $3.52 | $4.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.25 / $3.25 / $3.37
| Facility | | $3.25 | $3.25 | $3.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.25 / $3.25 / $3.37
| Professional | | $3.25 | $3.25 | $3.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.06 / $3.06 / $555.00
| Facility | | $3.06 | $3.06 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.24 / $3.24 / $4.48
| Professional | | $3.24 | $3.24 | $4.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.25 / $3.25 / $4.70
| Professional | | $3.25 | $3.25 | $4.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.37 / $3.37 / $3.37
| Facility | | $3.37 | $3.37 | $3.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.25 / $3.25 / $3.37
| Professional | | $3.25 | $3.25 | $3.37 |