- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.61 / $2.31 / $3.31
| Facility | | $1.61 | $2.31 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.92 / $2.12 / $2.52
| Professional | | $1.92 | $2.12 | $2.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.92 / $95.00 / $100.00
| Facility | | $1.92 | $95.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.97 / $2.31 / $411.09
| Professional | | $1.97 | $2.31 | $411.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.99 / $1.99 / $3.24
| Facility | | $1.99 | $1.99 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.11 / $2.39
| Professional | | $2.11 | $2.11 | $2.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.68 / $2.11 / $3.52
| Facility | | $1.68 | $2.11 | $3.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.56 / $2.11 / $3.52
| Professional | | $1.56 | $2.11 | $3.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.62 / $1.90 / $30.00
| Professional | | $1.62 | $1.90 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.59 / $2.19 / $4.76
| Facility | | $1.59 | $2.19 | $4.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.55 / $1.55 / $1.92
| Facility | | $1.55 | $1.55 | $1.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.81 / $2.06 / $3.73
| Professional | | $1.81 | $2.06 | $3.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.34 / $2.31 / $2.31
| Facility | | $1.34 | $2.31 | $2.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.31 / $2.52
| Professional | | $2.11 | $2.31 | $2.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.11 / $2.52
| Professional | | $2.11 | $2.11 | $2.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.63 / $2.11 / $2.11
| Professional | | $1.63 | $2.11 | $2.11 |