- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $41.69
| Facility | | $2.00 | $2.00 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $6.03 / $36.31
| Professional | | $3.02 | $6.03 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.24 / $4.07 / $10.23
| Facility | | $3.24 | $4.07 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.27 / $4.27 / $11.48
| Professional | | $4.27 | $4.27 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.00 / $13.80 / $20.42
| Facility | | $10.00 | $13.80 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.22 / $17.78 / $34.67
| Professional | | $11.22 | $17.78 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.90 / $4.90 / $4.90
| Professional | | $4.90 | $4.90 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $10.72 / $13.18
| Professional | | $9.77 | $10.72 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $10.00 / $22.39
| Professional | | $7.08 | $10.00 | $22.39 |
- 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
- $47.86 / $72.44 / $72.44
| Professional | | $47.86 | $72.44 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $9.55 / $9.55
| Professional | | $9.55 | $9.55 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.89 / $9.77 / $13.49
| Facility | | $5.89 | $9.77 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.90 / $4.90 / $9.33
| Professional | | $4.90 | $4.90 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $18.20 / $18.20
| Professional | | $18.20 | $18.20 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $8.13 / $11.48
| Professional | | $6.76 | $8.13 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.63 / $4.37 / $9.55
| Professional | | $3.63 | $4.37 | $9.55 |