- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.31 / $19.14 / $54.10
| Facility | | $7.31 | $19.14 | $54.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.41 / $7.15 / $11.59
| Professional | | $5.41 | $7.15 | $11.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.82 / $30.82 / $57.28
| Facility | | $10.82 | $30.82 | $57.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $5.50 / $9.27
| Professional | | $5.00 | $5.50 | $9.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.66 / $15.46 / $57.92
| Facility | | $9.66 | $15.46 | $57.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.66 / $9.66 / $10.88
| Facility | | $9.66 | $9.66 | $10.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.75 / $20.75 / $43.80
| Facility | | $6.75 | $20.75 | $43.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.12 / $6.86 / $15.87
| Professional | | $5.12 | $6.86 | $15.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.00 / $70.00 / $70.00
| Facility | | $45.00 | $70.00 | $70.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.80 / $9.66 / $12.56
| Facility | | $5.80 | $9.66 | $12.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.69 / $9.66 / $12.30
| Professional | | $8.69 | $9.66 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.28 / $9.66 / $26.56
| Facility | | $6.28 | $9.66 | $26.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.12 / $7.34 / $13.63
| Professional | | $5.12 | $7.34 | $13.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.54 / $9.66 / $11.59
| Facility | | $5.54 | $9.66 | $11.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $5.44 / $9.89
| Professional | | $4.05 | $5.44 | $9.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.77 / $4.66 / $9.66
| Professional | | $3.77 | $4.66 | $9.66 |