- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.24 / $3.31 / $6.61
| Facility | | $2.24 | $3.31 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $4.37
| Professional | | $2.00 | $2.00 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.75 / $2.75 / $2.75
| Facility | | $2.75 | $2.75 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $2.19 / $2.82
| Professional | | $2.19 | $2.19 | $2.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.19 / $5.89 / $8.71
| Facility | | $2.19 | $5.89 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $3.55 / $4.07
| Professional | | $2.24 | $3.55 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.75 / $2.75 / $5.75
| Facility | | $2.75 | $2.75 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.07 / $5.50 / $5.50
| Professional | | $4.07 | $5.50 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.95 / $2.75 / $100.00
| Facility | | $1.95 | $2.75 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.48 / $1.95 / $5.50
| Professional | | $1.48 | $1.95 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $50.12 / $85.11
| Professional | | $1.78 | $50.12 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $2.88 / $9.33
| Professional | | $2.19 | $2.88 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.19 / $85.11 / $100.00
| Facility | | $2.19 | $85.11 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $2.19 / $2.19
| Professional | | $2.19 | $2.19 | $2.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $2.40 / $2.95
| Professional | | $2.40 | $2.40 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.68 / $1.70
| Facility | | $0.02 | $0.68 | $1.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.87 / $2.19 / $3.31
| Professional | | $0.87 | $2.19 | $3.31 |