- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.98 / $9.02 / $9.43
| Facility | | $3.98 | $9.02 | $9.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.18 / $3.98 / $9.43
| Professional | | $3.18 | $3.98 | $9.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.36 / $80.00 / $80.00
| Facility | | $5.36 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.01 / $6.21 / $44.85
| Professional | | $4.01 | $6.21 | $44.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.51 / $3.51 / $3.51
| Facility | | $3.51 | $3.51 | $3.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.98 / $2.98 / $3.51
| Professional | | $2.98 | $2.98 | $3.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.64 / $6.12 / $15.93
| Facility | | $3.64 | $6.12 | $15.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.64 / $6.17 / $11.99
| Professional | | $3.64 | $6.17 | $11.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.12 / $6.12 / $60.00
| Professional | | $6.12 | $6.12 | $60.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.51 / $6.12 / $6.36
| Facility | | $5.51 | $6.12 | $6.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.36 / $6.88 / $11.96
| Facility | | $5.36 | $6.88 | $11.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.08 / $5.08 / $5.98
| Professional | | $5.08 | $5.08 | $5.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.83 / $5.98 / $5.98
| Facility | | $5.83 | $5.98 | $5.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.47 / $6.73 / $6.73
| Professional | | $4.47 | $6.73 | $6.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.80 / $4.20 / $5.34
| Professional | | $2.80 | $4.20 | $5.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.41 / $5.20 / $5.20
| Professional | | $3.41 | $5.20 | $5.20 |