- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.01 / $9.78 / $30.40
| Facility | | $4.01 | $9.78 | $30.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.65 / $3.87 / $4.73
| Professional | | $3.65 | $3.87 | $4.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.73 / $4.73 / $12.30
| Facility | | $4.73 | $4.73 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.83 / $9.72
| Professional | | $2.04 | $2.83 | $9.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.84 / $4.73 / $4.73
| Facility | | $2.84 | $4.73 | $4.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.45 / $4.73 / $4.73
| Professional | | $3.45 | $4.73 | $4.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.31 / $9.89 / $44.95
| Facility | | $3.31 | $9.89 | $44.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.25 / $4.75 / $29.38
| Professional | | $3.25 | $4.75 | $29.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.50 / $6.62 / $332.00
| Facility | | $3.50 | $6.62 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.16 / $2.84 / $8.66
| Professional | | $2.16 | $2.84 | $8.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.73 / $4.73 / $4.73
| Facility | | $4.73 | $4.73 | $4.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $4.73 / $5.71
| Professional | | $4.00 | $4.73 | $5.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.81 / $11.87 / $21.07
| Facility | | $3.81 | $11.87 | $21.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.15 / $3.15 / $3.15
| Professional | | $3.15 | $3.15 | $3.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.93 / $11.91 / $58.93
| Facility | | $5.93 | $11.91 | $58.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.36 / $5.15 / $9.50
| Professional | | $3.36 | $5.15 | $9.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.99 / $2.60 / $6.95
| Professional | | $1.99 | $2.60 | $6.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.44 / $5.44 / $15.86
| Facility | | $5.44 | $5.44 | $15.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.88 / $5.08 / $6.10
| Professional | | $3.88 | $5.08 | $6.10 |