- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.18 / $30.80 / $132.31
| Facility | | $5.18 | $30.80 | $132.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $3.53 / $5.34
| Professional | | $2.48 | $3.53 | $5.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $2.36 / $3.01
| Professional | | $1.78 | $2.36 | $3.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.75 / $10.45 / $22.05
| Facility | | $2.75 | $10.45 | $22.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.16 / $3.85 / $5.50
| Professional | | $2.16 | $3.85 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.93 / $7.27 / $46.00
| Facility | | $3.93 | $7.27 | $46.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $3.82 / $6.68
| Professional | | $2.95 | $3.82 | $6.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.93 / $3.93 / $3.93
| Facility | | $3.93 | $3.93 | $3.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.10 / $8.52 / $19.82
| Facility | | $3.10 | $8.52 | $19.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.21 / $4.33 / $6.77
| Professional | | $2.21 | $4.33 | $6.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $60.00 / $100.00
| Facility | | $50.00 | $60.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.45 / $4.88 / $6.90
| Professional | | $3.45 | $4.88 | $6.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.15 / $3.93 / $45.90
| Facility | | $3.15 | $3.93 | $45.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.67 / $3.93 / $6.53
| Professional | | $3.67 | $3.93 | $6.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $607.25 / $1,453.03 / $3,419.00
| Facility | | $607.25 | $1,453.03 | $3,419.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.15 / $3.93 / $9.77
| Facility | | $3.15 | $3.93 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $3.95 / $6.33
| Professional | | $2.37 | $3.95 | $6.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.36 / $3.21 / $3.93
| Professional | | $2.36 | $3.21 | $3.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.94 / $1.94 / $3.93
| Professional | | $1.94 | $1.94 | $3.93 |