- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.76 / $53.70 / $177.83
| Facility | | $6.76 | $53.70 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.63 / $5.13 / $8.32
| Professional | | $3.63 | $5.13 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $3.72 / $5.75
| Professional | | $2.75 | $3.72 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.76 / $18.20 / $33.88
| Facility | | $6.76 | $18.20 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $3.24 / $5.50
| Professional | | $3.16 | $3.24 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.25 / $8.91 / $91.20
| Facility | | $5.25 | $8.91 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $5.37 / $9.12
| Professional | | $3.98 | $5.37 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.75 / $5.75 / $5.75
| Facility | | $5.75 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.62 / $12.59 / $30.90
| Facility | | $5.62 | $12.59 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $5.89 / $12.30
| Professional | | $3.02 | $5.89 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $100.00 / $100.00
| Facility | | $60.26 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.90 / $5.50 / $8.71
| Professional | | $4.90 | $5.50 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.37 / $6.31 / $114.82
| Facility | | $4.37 | $6.31 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $5.13 / $9.12
| Professional | | $3.02 | $5.13 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.27 / $4.79 / $4.79
| Professional | | $4.27 | $4.79 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.57 / $5.75 / $16.98
| Facility | | $4.57 | $5.75 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.31 / $5.37 / $9.77
| Professional | | $3.31 | $5.37 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.00 / $3.47 / $5.75
| Facility | | $2.00 | $3.47 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $3.39 / $4.90
| Professional | | $2.40 | $3.39 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $5.75 / $5.75
| Professional | | $5.75 | $5.75 | $5.75 |