- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.65 / $7.20 / $103.16
| Facility | | $3.65 | $7.20 | $103.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.48 / $3.65 / $3.65
| Professional | | $3.48 | $3.65 | $3.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.48 / $7.34 / $11.83
| Facility | | $3.48 | $7.34 | $11.83 |
- 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
- $5.42 / $6.17 / $9.31
| Professional | | $5.42 | $6.17 | $9.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.28 / $3.28 / $3.48
| Facility | | $3.28 | $3.28 | $3.48 |
- 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
- $2.96 / $4.18 / $4.97
| Professional | | $2.96 | $4.18 | $4.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.56 / $3.48 / $10.94
| Facility | | $2.56 | $3.48 | $10.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.27 / $3.31 / $4.45
| Facility | | $2.27 | $3.31 | $4.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $3.31 / $4.45
| Professional | | $2.27 | $3.31 | $4.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.42 / $3.48 / $4.37
| Professional | | $3.42 | $3.48 | $4.37 |