- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.05 / $20.68 / $48.60
| Facility | | $5.05 | $20.68 | $48.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.20 / $4.55 / $26.55
| Professional | | $3.20 | $4.55 | $26.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.29 / $5.29 / $5.29
| Professional | | $5.29 | $5.29 | $5.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.44 / $14.18 / $293.00
| Facility | | $6.44 | $14.18 | $293.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.35 / $4.08 / $11.29
| Professional | | $2.35 | $4.08 | $11.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.52 / $38.29 / $75.31
| Facility | | $11.52 | $38.29 | $75.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.67 / $3.82 / $28.22
| Professional | | $2.67 | $3.82 | $28.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.82 / $7.72 / $19.23
| Facility | | $3.82 | $7.72 | $19.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.11 / $6.61 / $8.94
| Professional | | $3.11 | $6.61 | $8.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.70 / $5.88 / $9.41
| Professional | | $4.70 | $5.88 | $9.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.70 / $5.88 / $12.94
| Professional | | $4.70 | $5.88 | $12.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $60.00 / $100.00
| Facility | | $50.00 | $60.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.94 / $2.94 / $2.94
| Professional | | $2.94 | $2.94 | $2.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.00 / $6.47 / $16.18
| Facility | | $4.00 | $6.47 | $16.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.20 / $4.53 / $9.34
| Professional | | $3.20 | $4.53 | $9.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.63 / $20.63 / $20.63
| Professional | | $20.63 | $20.63 | $20.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.70 / $5.88 / $8.23
| Professional | | $4.70 | $5.88 | $8.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $2.60 / $8.67
| Professional | | $2.47 | $2.60 | $8.67 |