- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.01 / $5.01 / $5.01
| Facility | | $5.01 | $5.01 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $6.03 / $7.94
| Professional | | $3.98 | $6.03 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.71 / $14.45 / $30.90
| Professional | | $8.71 | $14.45 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.44 / $27.54 / $43.65
| Facility | | $23.44 | $27.54 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $18.20 / $21.38
| Professional | | $12.30 | $18.20 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.01 / $7.08 / $9.77
| Facility | | $5.01 | $7.08 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $38.02 / $50.12
| Professional | | $31.62 | $38.02 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.90 / $7.08 / $16.98
| Facility | | $4.90 | $7.08 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.13 / $5.75 / $70.79
| Professional | | $5.13 | $5.75 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $54.95 / $70.79
| Professional | | $32.36 | $54.95 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $19.50 / $28.84
| Professional | | $11.22 | $19.50 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.22 / $16.22 / $89.13
| Facility | | $16.22 | $16.22 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.38 / $40.74 / $74.13
| Professional | | $21.38 | $40.74 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.91 / $22.91 / $26.92
| Professional | | $22.91 | $22.91 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $5.37 / $10.23
| Professional | | $3.55 | $5.37 | $10.23 |