- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.22 / $2.76 / $4.51
| Facility | | $2.22 | $2.76 | $4.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.22 / $2.22 / $3.05
| Professional | | $2.22 | $2.22 | $3.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.78 / $1.78 / $2.22
| Facility | | $1.78 | $1.78 | $2.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.22 / $2.22
| Professional | | $2.11 | $2.22 | $2.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.18 / $2.18 / $2.29
| Facility | | $2.18 | $2.18 | $2.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $2.18 / $2.18
| Professional | | $2.18 | $2.18 | $2.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.10 / $2.10 / $2.38
| Facility | | $2.10 | $2.10 | $2.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.22 / $2.22 / $2.22
| Professional | | $2.22 | $2.22 | $2.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.10 / $3.15 / $332.00
| Facility | | $2.10 | $3.15 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $3.39
| Professional | | $2.41 | $2.41 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.22 / $2.22 / $2.31
| Facility | | $2.22 | $2.22 | $2.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.22 / $2.22 / $2.31
| Professional | | $2.22 | $2.22 | $2.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.10 / $2.10 / $555.00
| Facility | | $2.10 | $2.10 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.22 / $2.22 / $3.02
| Professional | | $2.22 | $2.22 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.22 / $3.20
| Professional | | $2.00 | $2.22 | $3.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.31 / $2.31 / $2.31
| Facility | | $2.31 | $2.31 | $2.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.22 / $2.22 / $2.31
| Professional | | $2.22 | $2.22 | $2.31 |