- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $24.55 / $47.86
| Facility | | $9.55 | $24.55 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.98 / $30.90
| Professional | | $3.02 | $3.98 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.45 / $10.96 / $23.44
| Facility | | $2.45 | $10.96 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $3.80 / $12.59
| Professional | | $2.14 | $3.80 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.47 / $33.11 / $61.66
| Facility | | $10.47 | $33.11 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $4.90 / $13.49
| Professional | | $3.47 | $4.90 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.16 / $7.94 / $16.98
| Facility | | $3.16 | $7.94 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.51 / $4.37 / $7.24
| Professional | | $2.51 | $4.37 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.80 / $4.68 / $7.59
| Professional | | $3.80 | $4.68 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $4.68 / $10.23
| Professional | | $3.72 | $4.68 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $70.79 / $100.00
| Facility | | $70.79 | $70.79 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $4.68 / $4.68
| Professional | | $2.34 | $4.68 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.72 / $5.37 / $13.80
| Facility | | $3.72 | $5.37 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.51 / $4.27 / $9.55
| Professional | | $2.51 | $4.27 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $16.60 / $16.60
| Professional | | $16.60 | $16.60 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $4.79 / $7.94
| Professional | | $3.72 | $4.79 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.09 / $2.95 / $4.68
| Facility | | $2.09 | $2.95 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.95 / $2.57 / $8.71
| Professional | | $1.95 | $2.57 | $8.71 |