- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.27 / $7.54 / $47.13
| Facility | | $3.27 | $7.54 | $47.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $2.98 / $4.01
| Professional | | $2.95 | $2.98 | $4.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.30 / $0.66 / $1.92
| Facility | | $0.30 | $0.66 | $1.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.30 / $0.30 / $0.30
| Professional | | $0.30 | $0.30 | $0.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.41 / $3.27 / $16.30
| Facility | | $1.41 | $3.27 | $16.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.87 / $2.87 / $2.87
| Professional | | $2.87 | $2.87 | $2.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.28 / $10.28 / $10.28
| Facility | | $10.28 | $10.28 | $10.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.78 / $2.95 / $2.95
| Facility | | $2.78 | $2.95 | $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
- $85.00 / $100.00 / $100.00
| Facility | | $85.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.87 / $8.36 / $59.65
| Facility | | $2.87 | $8.36 | $59.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $2.95 / $6.46
| Professional | | $2.15 | $2.95 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.86 / $2.95 / $4.22
| Facility | | $1.86 | $2.95 | $4.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $2.95 / $5.27
| Professional | | $2.75 | $2.95 | $5.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.46 / $5.46 / $5.46
| Facility | | $5.46 | $5.46 | $5.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $3.18 / $3.28
| Professional | | $2.95 | $3.18 | $3.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $3.57 / $3.98
| Professional | | $2.95 | $3.57 | $3.98 |