- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.88 / $2.66 / $2.97
| Facility | | $1.88 | $2.66 | $2.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.89 / $2.66 / $3.27
| Professional | | $1.89 | $2.66 | $3.27 |
- 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
- $1.20 / $1.20 / $1.20
| Professional | | $1.20 | $1.20 | $1.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.91 / $2.91 / $7.00
| Facility | | $2.91 | $2.91 | $7.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.12 / $2.12 / $2.12
| Professional | | $2.12 | $2.12 | $2.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.43 / $90.00 / $90.00
| Facility | | $6.43 | $90.00 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.27 / $28.28 / $29.40
| Professional | | $28.27 | $28.28 | $29.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.64 / $4.28 / $6.48
| Facility | | $2.64 | $4.28 | $6.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.06 / $3.06 / $3.06
| Professional | | $3.06 | $3.06 | $3.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.20 / $2.50 / $2.90
| Professional | | $2.20 | $2.50 | $2.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.66 / $4.30 / $6.48
| Facility | | $2.66 | $4.30 | $6.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.12 / $2.12 / $2.12
| Professional | | $2.12 | $2.12 | $2.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.81 / $2.15 / $3.81
| Professional | | $1.81 | $2.15 | $3.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.28 / $12.28 / $16.57
| Professional | | $12.28 | $12.28 | $16.57 |