- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.32 / $1.45 / $14.23
| Facility | | $1.32 | $1.45 | $14.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.39 / $2.16 / $14.23
| Professional | | $1.39 | $2.16 | $14.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.94 / $4.94 / $4.94
| Professional | | $4.94 | $4.94 | $4.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.72 / $2.06 / $5.47
| Facility | | $1.72 | $2.06 | $5.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.38 / $2.46 / $4.59
| Professional | | $2.38 | $2.46 | $4.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.19 / $6.75 / $10.42
| Facility | | $5.19 | $6.75 | $10.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.67 / $10.59 / $18.55
| Professional | | $2.67 | $10.59 | $18.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.87 / $2.97 / $3.92
| Facility | | $2.87 | $2.97 | $3.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $2.52 / $3.14
| Professional | | $2.52 | $2.52 | $3.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.95 / $4.94 / $5.93
| Professional | | $3.95 | $4.94 | $5.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.96 / $3.46 / $7.66
| Professional | | $2.96 | $3.46 | $7.66 |
- 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
- $24.60 / $24.60 / $37.04
| Professional | | $24.60 | $24.60 | $37.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.35 / $4.36 / $5.00
| Facility | | $1.35 | $4.36 | $5.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $2.97 / $4.46
| Professional | | $2.52 | $2.97 | $4.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.30 / $9.30 / $9.30
| Professional | | $9.30 | $9.30 | $9.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.95 / $5.78 / $7.52
| Professional | | $3.95 | $5.78 | $7.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.88 / $2.09 / $4.97
| Professional | | $1.88 | $2.09 | $4.97 |