- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.46 / $30.20 / $95.50
| Facility | | $6.46 | $30.20 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.02 / $8.32
| Professional | | $3.02 | $3.02 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.39 / $30.20 / $5,011.87
| Facility | | $22.39 | $30.20 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.31 / $3.31 / $4.17
| Professional | | $3.31 | $3.31 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.88 / $6.46 / $14.45
| Facility | | $2.88 | $6.46 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.63 / $5.01 / $7.59
| Professional | | $2.63 | $5.01 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $4.27 / $6.17
| Professional | | $2.00 | $4.27 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.27 / $4.27 / $4.27
| Facility | | $4.27 | $4.27 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.17 / $4.79 / $7.41
| Professional | | $4.17 | $4.79 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.76 / $26.30 / $97.72
| Facility | | $7.76 | $26.30 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $25.70 / $93.33
| Facility | | $6.31 | $25.70 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.98 / $15.49
| Professional | | $3.02 | $3.98 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.27 / $7.08 / $7.08
| Facility | | $4.27 | $7.08 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.07 / $7.08 / $7.41
| Professional | | $4.07 | $7.08 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.88 / $4.27 / $5.13
| Facility | | $2.88 | $4.27 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.95 / $3.09 / $8.13
| Professional | | $1.95 | $3.09 | $8.13 |