- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.60 / $3.41 / $8.74
| Facility | | $2.60 | $3.41 | $8.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $3.22 / $7.20
| Professional | | $2.25 | $3.22 | $7.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.25 / $8.25 / $8.25
| Professional | | $8.25 | $8.25 | $8.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.38 / $1.76 / $7.05
| Professional | | $1.38 | $1.76 | $7.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.30 / $3.55 / $3.55
| Facility | | $3.30 | $3.55 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $3.55 / $3.55
| Professional | | $3.55 | $3.55 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.96 / $4.96 / $4.96
| Facility | | $4.96 | $4.96 | $4.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.73 / $1.73 / $1.73
| Professional | | $1.73 | $1.73 | $1.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.23 / $7.74 / $332.00
| Facility | | $4.23 | $7.74 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.44 / $5.73 / $9.18
| Professional | | $4.44 | $5.73 | $9.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.50 / $6.50 / $6.50
| Facility | | $6.50 | $6.50 | $6.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $6.91 / $6.91
| Professional | | $3.55 | $6.91 | $6.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.96 / $4.96 / $597.00
| Facility | | $4.96 | $4.96 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.73 / $1.73 / $7.67
| Professional | | $1.73 | $1.73 | $7.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $2.47 / $4.67
| Professional | | $1.41 | $2.47 | $4.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.50 / $6.50 / $6.97
| Facility | | $6.50 | $6.50 | $6.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $6.50 / $6.91
| Professional | | $6.50 | $6.50 | $6.91 |