- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.12 / $9.52 / $65.90
| Facility | | $5.12 | $9.52 | $65.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.50 / $4.01 / $5.12
| Professional | | $3.50 | $4.01 | $5.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.18 / $11.10 / $11.74
| Facility | | $9.18 | $11.10 | $11.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.11 / $17.66
| Professional | | $2.11 | $2.11 | $17.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.26 / $11.61 / $12.07
| Facility | | $3.26 | $11.61 | $12.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.71 / $13.69 / $21.00
| Facility | | $11.71 | $13.69 | $21.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.96 / $11.50 / $13.06
| Professional | | $4.96 | $11.50 | $13.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.80 / $3.80 / $5.12
| Facility | | $3.80 | $3.80 | $5.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.50 / $3.84 / $70.00
| Facility | | $3.50 | $3.84 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.56 / $4.26 / $11.83
| Professional | | $2.56 | $4.26 | $11.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $8.37 / $85.00
| Professional | | $2.14 | $8.37 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.80 / $3.80 / $5.12
| Facility | | $3.80 | $3.80 | $5.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.23 / $10.30 / $14.30
| Professional | | $5.23 | $10.30 | $14.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.53 / $8.53 / $70.00
| Facility | | $8.53 | $8.53 | $70.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $2.78 / $4.18
| Professional | | $2.25 | $2.78 | $4.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.09 / $9.09 / $17.61
| Professional | | $9.09 | $9.09 | $17.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.61 / $17.61 / $23.31
| Professional | | $17.61 | $17.61 | $23.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.80 / $3.80 / $10.31
| Facility | | $3.80 | $3.80 | $10.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $3.58 / $11.70
| Professional | | $2.48 | $3.58 | $11.70 |