- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.08 / $7.30 / $20.64
| Facility | | $3.08 | $7.30 | $20.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $2.72 / $4.00
| Professional | | $2.54 | $2.72 | $4.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.64 / $3.64 / $9.46
| Facility | | $3.64 | $3.64 | $9.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.48 / $2.22 / $7.58
| Professional | | $1.48 | $2.22 | $7.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.18 / $3.64 / $3.64
| Facility | | $2.18 | $3.64 | $3.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.66 / $3.64 / $3.64
| Professional | | $2.66 | $3.64 | $3.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.54 / $7.07 / $30.30
| Facility | | $2.54 | $7.07 | $30.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.17 / $3.65 / $47.35
| Professional | | $2.17 | $3.65 | $47.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.64 / $10.10 / $332.00
| Facility | | $3.64 | $10.10 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.46 / $2.18 / $6.66
| Professional | | $1.46 | $2.18 | $6.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.70 / $3.46 / $4.09
| Professional | | $2.70 | $3.46 | $4.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.66 / $7.10 / $16.21
| Facility | | $2.66 | $7.10 | $16.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.26 / $8.52 / $39.25
| Facility | | $4.26 | $8.52 | $39.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $4.13 / $6.54
| Professional | | $2.37 | $4.13 | $6.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.28 / $3.28 / $3.64
| Facility | | $3.28 | $3.28 | $3.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.53 / $2.10 / $5.35
| Professional | | $1.53 | $2.10 | $5.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.19 / $4.19 / $11.03
| Facility | | $4.19 | $4.19 | $11.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.70 / $3.56 / $4.37
| Professional | | $2.70 | $3.56 | $4.37 |