- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.29 / $3.50 / $8.09
| Facility | | $2.29 | $3.50 | $8.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $2.97 / $4.05
| Professional | | $2.95 | $2.97 | $4.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $2.95 / $3.68
| Professional | | $2.95 | $2.95 | $3.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.36 / $2.36 / $2.48
| Facility | | $2.36 | $2.36 | $2.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.36 / $2.36 / $2.36
| Professional | | $2.36 | $2.36 | $2.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.50 / $2.78 / $2.95
| Facility | | $2.50 | $2.78 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $2.95 / $2.95
| Professional | | $2.95 | $2.95 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.78 / $4.73 / $332.00
| Facility | | $2.78 | $4.73 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.20 / $3.20 / $4.88
| Professional | | $3.20 | $3.20 | $4.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.95 / $2.95 / $3.06
| Facility | | $2.95 | $2.95 | $3.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $2.95 / $3.06
| Professional | | $2.95 | $2.95 | $3.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.59 / $1.22 / $3.77
| Facility | | $0.59 | $1.22 | $3.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.50 / $2.78 / $555.00
| Facility | | $2.50 | $2.78 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $2.95 / $5.21
| Professional | | $1.00 | $2.95 | $5.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $3.13 / $5.31
| Professional | | $2.95 | $3.13 | $5.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.06 / $3.06 / $3.06
| Facility | | $3.06 | $3.06 | $3.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.64 / $2.95 / $3.06
| Professional | | $1.64 | $2.95 | $3.06 |