- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.22 / $3.22 / $4.83
| Facility | | $3.22 | $3.22 | $4.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.78 / $3.33 / $3.43
| Professional | | $2.78 | $3.33 | $3.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $3.36 / $3.36
| Professional | | $2.81 | $3.36 | $3.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $2.81 / $3.09
| Facility | | $2.81 | $2.81 | $3.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $2.81 / $2.81
| Professional | | $2.81 | $2.81 | $2.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.96 / $3.04 / $3.43
| Facility | | $2.96 | $3.04 | $3.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.43 / $3.43 / $3.43
| Professional | | $3.43 | $3.43 | $3.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.43 / $3.43 / $5.93
| Facility | | $3.43 | $3.43 | $5.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.43 / $3.43 / $3.94
| Professional | | $3.43 | $3.43 | $3.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.42 / $3.56 / $3.56
| Facility | | $3.42 | $3.56 | $3.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.42 / $3.56 / $3.56
| Professional | | $3.42 | $3.56 | $3.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.04 / $3.04 / $597.00
| Facility | | $3.04 | $3.04 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.43 / $3.43 / $4.97
| Professional | | $3.43 | $3.43 | $4.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.36 / $4.54
| Professional | | $3.02 | $3.36 | $4.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.42 / $3.42 / $3.42
| Facility | | $3.42 | $3.42 | $3.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.42 / $3.42 / $3.56
| Professional | | $3.42 | $3.42 | $3.56 |