- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.04 / $11.42 / $60.89
| Facility | | $4.04 | $11.42 | $60.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.41 / $4.16 / $6.05
| Professional | | $3.41 | $4.16 | $6.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $2.27 / $2.27
| Professional | | $2.27 | $2.27 | $2.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.76 / $4.76 / $12.38
| Facility | | $4.76 | $4.76 | $12.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $2.85 / $10.38
| Professional | | $2.19 | $2.85 | $10.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.86 / $4.76 / $4.76
| Facility | | $2.86 | $4.76 | $4.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $4.76 / $4.76
| Professional | | $3.47 | $4.76 | $4.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.33 / $9.89 / $47.90
| Facility | | $3.33 | $9.89 | $47.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $5.78 / $10.64
| Professional | | $3.47 | $5.78 | $10.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.50 / $6.66 / $332.00
| Facility | | $3.50 | $6.66 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.19 / $4.76 / $8.71
| Professional | | $2.19 | $4.76 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.76 / $4.76 / $4.76
| Facility | | $4.76 | $4.76 | $4.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $4.76 / $6.10
| Professional | | $4.05 | $4.76 | $6.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.83 / $12.09 / $26.27
| Facility | | $3.83 | $12.09 | $26.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.93 / $11.91 / $62.80
| Facility | | $5.93 | $11.91 | $62.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.51 / $5.78 / $10.03
| Professional | | $3.51 | $5.78 | $10.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.86 / $6.99
| Professional | | $2.00 | $2.86 | $6.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.47 / $5.47 / $16.94
| Facility | | $5.47 | $5.47 | $16.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $5.14 / $6.14
| Professional | | $4.05 | $5.14 | $6.14 |