- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.43 / $5.73 / $201.08
| Facility | | $3.43 | $5.73 | $201.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.43 / $3.51 / $5.73
| Professional | | $3.43 | $3.51 | $5.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.28 / $5.13 / $7.10
| Facility | | $3.28 | $5.13 | $7.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.48 / $3.48 / $3.77
| Professional | | $3.48 | $3.48 | $3.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.48 / $7.82 / $9.35
| Professional | | $3.48 | $7.82 | $9.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.82 / $4.98 / $14.92
| Facility | | $2.82 | $4.98 | $14.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.48 / $3.84 / $8.90
| Professional | | $3.48 | $3.84 | $8.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.42 / $4.00 / $10.29
| Facility | | $3.42 | $4.00 | $10.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.28 / $5.13 / $10.72
| Facility | | $3.28 | $5.13 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.77 / $4.53 / $9.83
| Professional | | $3.77 | $4.53 | $9.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.96 / $7.91 / $20.84
| Facility | | $3.96 | $7.91 | $20.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.48 / $3.48 / $3.48
| Professional | | $3.48 | $3.48 | $3.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.48 / $3.48 / $3.48
| Professional | | $3.48 | $3.48 | $3.48 |