- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.20 / $34.61 / $70.98
| Facility | | $7.20 | $34.61 | $70.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $2.15 / $14.86
| Professional | | $2.06 | $2.15 | $14.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.09 / $6.16 / $6.52
| Facility | | $5.09 | $6.16 | $6.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.76 / $1.76 / $9.77
| Professional | | $1.76 | $1.76 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.58 / $6.43 / $6.68
| Facility | | $1.58 | $6.43 | $6.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $2.37 / $2.37
| Professional | | $2.37 | $2.37 | $2.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $7.37 / $11.31
| Facility | | $6.31 | $7.37 | $11.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $7.07 / $8.03
| Professional | | $2.48 | $7.07 | $8.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.11 / $2.11 / $2.84
| Facility | | $2.11 | $2.11 | $2.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.11 / $27.37 / $65.59
| Facility | | $2.11 | $27.37 | $65.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $3.23 / $12.23
| Professional | | $1.42 | $3.23 | $12.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.19 / $3.56 / $85.00
| Professional | | $1.19 | $3.56 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.11 / $2.11 / $2.84
| Facility | | $2.11 | $2.11 | $2.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.89 / $5.54 / $35.15
| Professional | | $2.89 | $5.54 | $35.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.74 / $4.74 / $100.00
| Facility | | $4.74 | $4.74 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.26 / $1.63 / $2.35
| Professional | | $1.26 | $1.63 | $2.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $5.05 / $7.21
| Professional | | $5.05 | $5.05 | $7.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.21 / $11.24 / $12.94
| Professional | | $7.21 | $11.24 | $12.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $2.37 / $6.49
| Professional | | $1.42 | $2.37 | $6.49 |