- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.58 / $50.83 / $162.75
| Facility | | $3.58 | $50.83 | $162.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $3.10 / $4.70
| Professional | | $2.56 | $3.10 | $4.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.14 / $2.04 / $2.56
| Professional | | $1.14 | $2.04 | $2.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.73 / $11.10 / $22.50
| Facility | | $4.73 | $11.10 | $22.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $4.23 / $5.50
| Professional | | $2.35 | $4.23 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.95 / $6.41 / $35.60
| Facility | | $3.95 | $6.41 | $35.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.99 / $4.00 / $6.83
| Professional | | $2.99 | $4.00 | $6.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.26 / $5.98 / $5.98
| Facility | | $4.26 | $5.98 | $5.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.98 / $8.35 / $19.64
| Facility | | $2.98 | $8.35 | $19.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $3.87 / $7.35
| Professional | | $2.25 | $3.87 | $7.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $60.00 / $100.00
| Facility | | $50.00 | $60.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.11 / $4.26 / $34.21
| Facility | | $3.11 | $4.26 | $34.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.84 / $4.26 / $4.70
| Professional | | $3.84 | $4.26 | $4.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.15 / $48.11 / $131.11
| Facility | | $35.15 | $48.11 | $131.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.11 / $4.26 / $10.54
| Facility | | $3.11 | $4.26 | $10.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $3.88 / $6.91
| Professional | | $2.25 | $3.88 | $6.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $2.90 / $4.26
| Professional | | $2.56 | $2.90 | $4.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.67 / $1.75 / $4.26
| Professional | | $1.67 | $1.75 | $4.26 |