- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.89 / $2.08 / $3.24
| Facility | | $1.89 | $2.08 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $1.87 / $2.08
| Professional | | $1.86 | $1.87 | $2.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.76 / $2.64 / $85.00
| Facility | | $1.76 | $2.64 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $1.86 / $7.16
| Professional | | $1.85 | $1.86 | $7.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.75 / $1.75 / $3.58
| Facility | | $1.75 | $1.75 | $3.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $1.86 / $2.27
| Professional | | $1.86 | $1.86 | $2.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.86 / $2.46 / $5.51
| Facility | | $1.86 | $2.46 | $5.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $2.46 / $4.59
| Professional | | $1.86 | $2.46 | $4.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.74 / $2.08 / $75.00
| Professional | | $1.74 | $2.08 | $75.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.56 / $1.95 / $4.68
| Facility | | $1.56 | $1.95 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.43 / $2.64 / $4.46
| Facility | | $1.43 | $2.64 | $4.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.75 / $2.02 / $3.12
| Professional | | $1.75 | $2.02 | $3.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.76 / $2.12 / $4.11
| Facility | | $1.76 | $2.12 | $4.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.77 / $1.86 / $1.93
| Professional | | $1.77 | $1.86 | $1.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $1.86 / $1.92
| Professional | | $1.86 | $1.86 | $1.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.62 / $1.86 / $1.86
| Professional | | $1.62 | $1.86 | $1.86 |