- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.35 / $148.40 / $320.63
| Facility | | $11.35 | $148.40 | $320.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.05 / $7.48 / $9.82
| Professional | | $5.05 | $7.48 | $9.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.04 / $5.05 / $8.41
| Professional | | $4.04 | $5.05 | $8.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.08 / $26.16 / $49.31
| Facility | | $9.08 | $26.16 | $49.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.46 / $5.05 / $8.41
| Professional | | $4.46 | $5.05 | $8.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.41 / $13.46 / $51.51
| Facility | | $8.41 | $13.46 | $51.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.31 / $8.41 / $12.62
| Professional | | $6.31 | $8.41 | $12.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.24 / $8.24 / $8.41
| Facility | | $8.24 | $8.24 | $8.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.88 / $18.48 / $42.32
| Facility | | $5.88 | $18.48 | $42.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.46 / $6.14 / $17.39
| Professional | | $4.46 | $6.14 | $17.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.06 / $72.93 / $100.00
| Facility | | $58.06 | $72.93 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.73 / $8.41 / $15.38
| Facility | | $6.73 | $8.41 | $15.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.15 / $8.41 / $10.95
| Professional | | $7.15 | $8.41 | $10.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.73 / $8.41 / $21.09
| Facility | | $6.73 | $8.41 | $21.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.46 / $6.46 / $12.03
| Professional | | $4.46 | $6.46 | $12.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.94 / $5.76 / $6.34
| Facility | | $2.94 | $5.76 | $6.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.53 / $4.84 / $6.96
| Professional | | $3.53 | $4.84 | $6.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.28 / $4.15 / $8.41
| Professional | | $3.28 | $4.15 | $8.41 |