- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.70 / $2.40 / $2.67
| Facility | | $1.70 | $2.40 | $2.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.70 / $2.39 / $2.94
| Professional | | $1.70 | $2.39 | $2.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,456.92 / $5,821.21 / $8,577.84
| Facility | | $5,456.92 | $5,821.21 | $8,577.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.20 / $0.20 / $0.20
| Professional | | $0.20 | $0.20 | $0.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.57 / $1.57 / $1.57
| Facility | | $1.57 | $1.57 | $1.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.53 / $1.53 / $85.00
| Facility | | $1.53 | $1.53 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.30 / $1.50 / $2.47
| Professional | | $1.30 | $1.50 | $2.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $100.00 / $100.00
| Facility | | $75.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.00 / $26.50 / $27.56
| Professional | | $14.00 | $26.50 | $27.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.37 / $3.85 / $5.98
| Facility | | $2.37 | $3.85 | $5.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.12 / $2.75 / $2.75
| Professional | | $0.12 | $2.75 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.84 / $12.36 / $16.20
| Professional | | $10.84 | $12.36 | $16.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.40 / $3.90 / $5.98
| Facility | | $2.40 | $3.90 | $5.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.30 / $2.47 / $2.47
| Professional | | $1.30 | $2.47 | $2.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.63 / $1.93 / $3.81
| Professional | | $1.63 | $1.93 | $3.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.07 / $3.07 / $4.13
| Professional | | $3.07 | $3.07 | $4.13 |