- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.02 / $52.29 / $107.52
| Facility | | $6.02 | $52.29 | $107.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.69 / $12.32 / $32.60
| Professional | | $4.69 | $12.32 | $32.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.79 / $13.05 / $13.81
| Facility | | $10.79 | $13.05 | $13.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.84 / $2.84 / $20.78
| Professional | | $2.84 | $2.84 | $20.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.01 / $13.61 / $15.54
| Facility | | $5.01 | $13.61 | $15.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $5.01 / $5.01
| Professional | | $5.01 | $5.01 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.52 / $15.80 / $24.23
| Facility | | $13.52 | $15.80 | $24.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.78 / $14.70 / $16.70
| Professional | | $5.78 | $14.70 | $16.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.66 / $2.66 / $6.02
| Facility | | $2.66 | $2.66 | $6.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.66 / $5.01 / $80.00
| Facility | | $2.66 | $5.01 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.01 / $6.83 / $18.17
| Professional | | $4.01 | $6.83 | $18.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.50 / $9.82 / $85.00
| Professional | | $2.50 | $9.82 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.66 / $2.66 / $6.02
| Facility | | $2.66 | $2.66 | $6.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.13 / $12.67 / $30.80
| Professional | | $6.13 | $12.67 | $30.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.03 / $10.03 / $80.00
| Facility | | $10.03 | $10.03 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.66 / $2.66 / $3.27
| Professional | | $2.66 | $2.66 | $3.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.35 / $9.35 / $10.69
| Professional | | $9.35 | $9.35 | $10.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.35 / $19.98 / $27.41
| Professional | | $9.35 | $19.98 | $27.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.01 / $6.02 / $16.32
| Professional | | $3.01 | $6.02 | $16.32 |