- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.64 / $57.38 / $162.61
| Facility | | $8.64 | $57.38 | $162.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.46 / $6.42 / $7.20
| Professional | | $4.46 | $6.42 | $7.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.46 / $4.90 / $7.20
| Professional | | $3.46 | $4.90 | $7.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.92 / $22.61 / $41.54
| Facility | | $7.92 | $22.61 | $41.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.96 / $5.00 / $5.50
| Professional | | $3.96 | $5.00 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.48 / $11.52 / $50.48
| Facility | | $6.48 | $11.52 | $50.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.40 / $7.00 / $11.52
| Professional | | $5.40 | $7.00 | $11.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.20 / $7.20 / $7.20
| Facility | | $7.20 | $7.20 | $7.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.03 / $15.86 / $37.02
| Facility | | $5.03 | $15.86 | $37.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $7.11 / $12.43
| Professional | | $4.05 | $7.11 | $12.43 |
- 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
- $6.38 / $10.40 / $11.80
| Professional | | $6.38 | $10.40 | $11.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.76 / $7.20 / $45.00
| Facility | | $5.76 | $7.20 | $45.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.48 / $7.20 / $11.91
| Professional | | $6.48 | $7.20 | $11.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,169.58 / $1,584.34 / $2,714.18
| Facility | | $1,169.58 | $1,584.34 | $2,714.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.80 / $7.20 / $17.94
| Facility | | $5.80 | $7.20 | $17.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.82 / $7.20 / $11.97
| Professional | | $3.82 | $7.20 | $11.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $4.12 / $5.96
| Professional | | $3.02 | $4.12 | $5.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.56 / $3.56 / $7.20
| Professional | | $3.56 | $3.56 | $7.20 |