- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.30 / $1.42 / $13.78
| Facility | | $1.30 | $1.42 | $13.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.32 / $2.11 / $13.27
| Professional | | $1.32 | $2.11 | $13.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.58 / $3.58 / $4.76
| Professional | | $3.58 | $3.58 | $4.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.75 / $2.10 / $5.56
| Facility | | $1.75 | $2.10 | $5.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $2.42 / $4.07
| Professional | | $2.37 | $2.42 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.01 / $6.51 / $10.07
| Facility | | $5.01 | $6.51 | $10.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.58 / $8.03 / $17.94
| Professional | | $2.58 | $8.03 | $17.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.60 / $2.92 / $4.05
| Facility | | $2.60 | $2.92 | $4.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $2.48 / $3.24
| Professional | | $2.48 | $2.48 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.82 / $4.76 / $5.72
| Professional | | $3.82 | $4.76 | $5.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.86 / $3.34 / $7.39
| Professional | | $2.86 | $3.34 | $7.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $80.00 / $80.00
| Facility | | $75.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.15 / $24.15 / $36.38
| Professional | | $24.15 | $24.15 | $36.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.32 / $4.21 / $4.82
| Facility | | $1.32 | $4.21 | $4.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $2.92 / $4.22
| Professional | | $2.48 | $2.92 | $4.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.01 / $9.01 / $9.01
| Professional | | $9.01 | $9.01 | $9.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.82 / $5.58 / $7.26
| Professional | | $3.82 | $5.58 | $7.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $2.06 / $4.82
| Professional | | $1.86 | $2.06 | $4.82 |