- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.96 / $7.66 / $14.63
| Facility | | $6.96 | $7.66 | $14.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.15 / $7.07 / $9.42
| Professional | | $2.15 | $7.07 | $9.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $9.30 / $15.06
| Professional | | $5.62 | $9.30 | $15.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.40 / $12.07 / $29.50
| Facility | | $8.40 | $12.07 | $29.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.86 / $8.86 / $8.86
| Professional | | $8.86 | $8.86 | $8.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.31 / $2.66 / $10.76
| Facility | | $1.31 | $2.66 | $10.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.07 / $8.07 / $8.07
| Professional | | $8.07 | $8.07 | $8.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.32 / $4.32 / $4.32
| Facility | | $4.32 | $4.32 | $4.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.96 / $6.96 / $12.61
| Facility | | $6.96 | $6.96 | $12.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.08 / $5.08 / $5.08
| Professional | | $5.08 | $5.08 | $5.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.84 / $90.00 / $90.00
| Facility | | $21.84 | $90.00 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.58 / $53.58 / $80.70
| Professional | | $53.58 | $53.58 | $80.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.65 / $8.66 / $11.96
| Facility | | $5.65 | $8.66 | $11.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.15 / $10.22 / $12.37
| Professional | | $9.15 | $10.22 | $12.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.76 / $13.20 / $24.21
| Professional | | $10.76 | $13.20 | $24.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.65 / $8.80 / $11.96
| Facility | | $5.65 | $8.80 | $11.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.08 / $5.08 / $8.94
| Professional | | $5.08 | $5.08 | $8.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.80 / $4.87 / $7.38
| Professional | | $3.80 | $4.87 | $7.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.61 / $10.76 / $14.53
| Professional | | $3.61 | $10.76 | $14.53 |