- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.52 / $7.32 / $16.44
| Facility | | $2.52 | $7.32 | $16.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $2.25 / $7.39
| Professional | | $2.18 | $2.25 | $7.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $2.18 / $6.44
| Professional | | $2.18 | $2.18 | $6.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.17 / $3.17 / $3.33
| Facility | | $3.17 | $3.17 | $3.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.17 / $3.17 / $3.17
| Professional | | $3.17 | $3.17 | $3.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.06 / $2.06 / $3.18
| Facility | | $2.06 | $2.06 | $3.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $2.18 / $2.18
| Professional | | $2.18 | $2.18 | $2.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.06 / $3.09 / $332.00
| Facility | | $2.06 | $3.09 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $2.37 / $3.24
| Professional | | $2.37 | $2.37 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.18 / $2.18 / $2.45
| Facility | | $2.18 | $2.18 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $2.18 / $2.45
| Professional | | $2.18 | $2.18 | $2.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.82 / $2.75 / $5.85
| Facility | | $1.82 | $2.75 | $5.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.06 / $2.06 / $555.00
| Facility | | $2.06 | $2.06 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $2.18 / $6.44
| Professional | | $1.00 | $2.18 | $6.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $2.18 / $5.67
| Professional | | $2.18 | $2.18 | $5.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.45 / $2.45 / $2.45
| Facility | | $2.45 | $2.45 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $2.25 / $3.39
| Professional | | $2.18 | $2.25 | $3.39 |