- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.68 / $28.18 / $91.20
| Facility | | $4.68 | $28.18 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $5.01 / $8.32
| Professional | | $3.16 | $5.01 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.70 / $2.63 / $9.55
| Professional | | $1.70 | $2.63 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.94 / $20.42 / $35.48
| Facility | | $7.94 | $20.42 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.39 / $4.90 / $6.03
| Professional | | $3.39 | $4.90 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.62 / $8.51 / $10.96
| Facility | | $5.62 | $8.51 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.17 / $7.41 / $7.41
| Facility | | $6.17 | $7.41 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.75 / $12.88 / $32.36
| Facility | | $5.75 | $12.88 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.24 / $4.17 / $11.75
| Professional | | $3.24 | $4.17 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $100.00 / $100.00
| Facility | | $60.26 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.68 / $6.17 / $81.28
| Facility | | $4.68 | $6.17 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $5.25 / $8.32
| Professional | | $3.16 | $5.25 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.57 / $5.13 / $5.13
| Professional | | $4.57 | $5.13 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.68 / $6.17 / $17.78
| Facility | | $4.68 | $6.17 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.16 / $4.17 / $9.33
| Professional | | $3.16 | $4.17 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.19 / $3.72 / $6.17
| Facility | | $2.19 | $3.72 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $3.31 / $5.13
| Professional | | $2.57 | $3.31 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $2.40 / $6.17
| Professional | | $2.40 | $2.40 | $6.17 |