- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.63 / $4.28 / $415.30
| Facility | | $3.63 | $4.28 | $415.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.63 / $6.33 / $39.14
| Professional | | $3.63 | $6.33 | $39.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.40 / $5.23 / $8.85
| Facility | | $4.40 | $5.23 | $8.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.01 / $6.01 / $12.62
| Professional | | $6.01 | $6.01 | $12.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.23 / $19.98 / $28.66
| Facility | | $14.23 | $19.98 | $28.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.77 / $34.29 / $51.01
| Professional | | $15.77 | $34.29 | $51.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.93 / $6.93 / $6.93
| Professional | | $6.93 | $6.93 | $6.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.57 / $14.93 / $18.32
| Professional | | $13.57 | $14.93 | $18.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $16.96 / $31.21
| Professional | | $6.00 | $16.96 | $31.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.55 / $80.00 / $85.00
| Facility | | $27.55 | $80.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.58 / $67.58 / $101.78
| Professional | | $67.58 | $67.58 | $101.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.69 / $13.57 / $18.59
| Facility | | $9.69 | $13.57 | $18.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.93 / $6.93 / $14.51
| Professional | | $6.93 | $6.93 | $14.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.60 / $25.60 / $25.60
| Professional | | $25.60 | $25.60 | $25.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.11 / $5.71 / $11.81
| Professional | | $1.11 | $5.71 | $11.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.41 / $6.11 / $16.05
| Professional | | $5.41 | $6.11 | $16.05 |