- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.38 / $2.88 / $390.52
| Facility | | $2.38 | $2.88 | $390.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.20 / $2.88 / $3.72
| Professional | | $1.20 | $2.88 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.07 / $3.07 / $3.07
| Professional | | $3.07 | $3.07 | $3.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.01 / $4.59 / $12.05
| Facility | | $3.01 | $4.59 | $12.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $1.86 / $1.86
| Professional | | $1.86 | $1.86 | $1.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.73 / $3.61 / $4.38
| Facility | | $2.73 | $3.61 | $4.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.29 / $4.38 / $4.82
| Professional | | $3.29 | $4.38 | $4.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.69 / $2.69 / $2.69
| Facility | | $2.69 | $2.69 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.63 / $2.63 / $6.65
| Facility | | $2.63 | $2.63 | $6.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $2.24 / $2.24
| Professional | | $2.24 | $2.24 | $2.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.89 / $80.00 / $85.00
| Facility | | $8.89 | $80.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.81 / $21.81 / $27.90
| Professional | | $21.81 | $21.81 | $27.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.88 / $3.44 / $5.34
| Facility | | $2.88 | $3.44 | $5.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.36 / $4.16 / $4.38
| Professional | | $3.36 | $4.16 | $4.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.40 / $6.30 / $8.60
| Professional | | $5.40 | $6.30 | $8.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.88 / $3.43 / $5.34
| Facility | | $2.88 | $3.43 | $5.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $2.24 / $2.98
| Professional | | $2.24 | $2.24 | $2.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.55 / $2.02 / $2.66
| Professional | | $1.55 | $2.02 | $2.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.89 / $4.38 / $5.91
| Professional | | $0.89 | $4.38 | $5.91 |