- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.04 / $8.31 / $15.44
| Facility | | $4.04 | $8.31 | $15.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $4.13 / $4.75
| Professional | | $2.52 | $4.13 | $4.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.75 / $4.75 / $12.35
| Facility | | $4.75 | $4.75 | $12.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $2.87 / $10.71
| Professional | | $2.27 | $2.87 | $10.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.85 / $4.75 / $4.75
| Facility | | $2.85 | $4.75 | $4.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $4.75 / $4.75
| Professional | | $3.47 | $4.75 | $4.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.32 / $9.89 / $48.04
| Facility | | $3.32 | $9.89 | $48.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $5.48 / $26.00
| Professional | | $3.47 | $5.48 | $26.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.00 / $6.92 / $332.00
| Facility | | $4.00 | $6.92 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.90 / $2.83 / $8.69
| Professional | | $1.90 | $2.83 | $8.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.55 / $4.55 / $4.55
| Facility | | $4.55 | $4.55 | $4.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.18 / $4.55 / $6.31
| Professional | | $4.18 | $4.55 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $2.27 / $2.27
| Professional | | $2.27 | $2.27 | $2.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.22 / $6.60 / $24.32
| Facility | | $3.22 | $6.60 | $24.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.93 / $11.91 / $62.80
| Facility | | $5.93 | $11.91 | $62.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.76 / $6.23 / $9.78
| Professional | | $3.76 | $6.23 | $9.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.85 / $6.98
| Professional | | $2.00 | $2.85 | $6.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.46 / $5.46 / $17.52
| Facility | | $5.46 | $5.46 | $17.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.18 / $5.33 / $9.76
| Professional | | $4.18 | $5.33 | $9.76 |