- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.82 / $6.31 / $141.25
| Facility | | $2.82 | $6.31 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $4.68
| Professional | | $2.00 | $2.00 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.47 / $3.47 / $3.47
| Facility | | $3.47 | $3.47 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $2.75 / $3.55
| Professional | | $2.75 | $2.75 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.75 / $6.46 / $11.22
| Facility | | $2.75 | $6.46 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.82 / $3.55 / $5.13
| Professional | | $2.82 | $3.55 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.55 / $3.55 / $7.94
| Facility | | $3.55 | $3.55 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.37 / $7.08 / $18.62
| Professional | | $5.37 | $7.08 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.47 / $3.47 / $7.94
| Facility | | $3.47 | $3.47 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $3.47 / $7.08
| Professional | | $3.47 | $3.47 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $64.57 / $85.11
| Professional | | $2.75 | $64.57 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $2.95 / $11.75
| Professional | | $2.75 | $2.95 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.75 / $2.75 / $125.89
| Facility | | $2.75 | $2.75 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $2.75 / $2.75
| Professional | | $2.75 | $2.75 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.39 / $3.39 / $10.72
| Professional | | $3.39 | $3.39 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.47 / $3.47 / $3.47
| Facility | | $3.47 | $3.47 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $2.75 / $4.37
| Professional | | $2.75 | $2.75 | $4.37 |