- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $1.00 / $24.55
| Facility | | $1.00 | $1.00 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.98 / $21.38
| Professional | | $2.00 | $3.98 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.09 / $2.63 / $6.61
| Facility | | $2.09 | $2.63 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.82 / $2.82 / $6.76
| Professional | | $2.82 | $2.82 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $8.13 / $11.75
| Facility | | $5.89 | $8.13 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.31 / $10.47 / $20.42
| Professional | | $6.31 | $10.47 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.24 / $3.98 / $3.98
| Facility | | $3.24 | $3.98 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.39 / $3.39 / $3.98
| Professional | | $3.39 | $3.39 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.57 / $5.75 / $7.76
| Professional | | $4.57 | $5.75 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.89 / $5.13 / $10.00
| Professional | | $3.89 | $5.13 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $85.11
| Facility | | $79.43 | $79.43 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $48.98 / $48.98
| Professional | | $31.62 | $48.98 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.62 / $5.62 / $5.62
| Professional | | $5.62 | $5.62 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.91 / $5.75 / $7.59
| Facility | | $1.91 | $5.75 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.39 / $3.39 / $5.50
| Professional | | $3.39 | $3.39 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.47 / $10.47 / $10.47
| Professional | | $10.47 | $10.47 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.57 / $5.13 / $7.94
| Professional | | $4.57 | $5.13 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.46 / $2.51 / $3.02
| Facility | | $0.46 | $2.51 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.51 / $2.82 / $5.75
| Professional | | $2.51 | $2.82 | $5.75 |