- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.73 / $4.58 / $30.52
| Facility | | $2.73 | $4.58 | $30.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.38 / $2.73 / $6.33
| Professional | | $2.38 | $2.73 | $6.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.97 / $2.90 / $3.93
| Facility | | $1.97 | $2.90 | $3.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.97 / $2.73 / $6.51
| Professional | | $1.97 | $2.73 | $6.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.46 / $6.92 / $11.48
| Facility | | $6.46 | $6.92 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.78 / $2.78 / $4.65
| Professional | | $2.78 | $2.78 | $4.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.57 / $2.57 / $6.46
| Facility | | $2.57 | $2.57 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $2.73 / $6.46
| Professional | | $2.73 | $2.73 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.51 / $1.70 / $2.08
| Professional | | $1.51 | $1.70 | $2.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.46 / $3.14 / $7.29
| Professional | | $2.46 | $3.14 | $7.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $100.00 / $100.00
| Facility | | $75.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.57 / $2.73 / $4.01
| Facility | | $2.57 | $2.73 | $4.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $2.86 / $9.11
| Professional | | $2.73 | $2.86 | $9.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.73 / $20.73 / $20.73
| Professional | | $20.73 | $20.73 | $20.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $3.00 / $4.63
| Professional | | $2.18 | $3.00 | $4.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.73 / $2.73 / $7.02
| Professional | | $2.73 | $2.73 | $7.02 |