- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.17 / $41.25 / $83.70
| Facility | | $7.17 | $41.25 | $83.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.85 / $8.43 / $14.73
| Professional | | $5.85 | $8.43 | $14.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.53 / $6.56 / $9.44
| Professional | | $4.53 | $6.56 | $9.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.60 / $31.06 / $54.47
| Facility | | $11.60 | $31.06 | $54.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $5.50 / $8.40
| Professional | | $5.00 | $5.50 | $8.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.61 / $14.16 / $60.19
| Facility | | $6.61 | $14.16 | $60.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.66 / $9.00 / $14.16
| Professional | | $5.66 | $9.00 | $14.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.25 / $9.25 / $9.44
| Facility | | $9.25 | $9.25 | $9.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.60 / $20.63 / $42.97
| Facility | | $6.60 | $20.63 | $42.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $6.86 / $15.87
| Professional | | $5.00 | $6.86 | $15.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $60.00 / $60.00
| Facility | | $50.00 | $60.00 | $60.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.55 / $9.44 / $14.50
| Facility | | $7.55 | $9.44 | $14.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.50 / $9.44 / $12.30
| Professional | | $8.50 | $9.44 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $458.00 / $1,465.41 / $3,176.45
| Facility | | $458.00 | $1,465.41 | $3,176.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.55 / $9.44 / $24.53
| Facility | | $7.55 | $9.44 | $24.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $7.26 / $13.63
| Professional | | $5.00 | $7.26 | $13.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.96 / $5.40 / $7.71
| Professional | | $3.96 | $5.40 | $7.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.68 / $4.66 / $9.44
| Professional | | $3.68 | $4.66 | $9.44 |