- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.97 / $3.25 / $31.89
| Facility | | $2.97 | $3.25 | $31.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.97 / $5.15 / $31.89
| Professional | | $2.97 | $5.15 | $31.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.59 / $4.26 / $7.22
| Facility | | $3.59 | $4.26 | $7.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.90 / $4.90 / $10.28
| Professional | | $4.90 | $4.90 | $10.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.61 / $16.30 / $23.38
| Facility | | $11.61 | $16.30 | $23.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.86 / $27.94 / $41.54
| Professional | | $12.86 | $27.94 | $41.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.64 / $5.64 / $5.64
| Professional | | $5.64 | $5.64 | $5.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.05 / $12.16 / $14.92
| Professional | | $11.05 | $12.16 | $14.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.63 / $13.81 / $25.42
| Professional | | $6.63 | $13.81 | $25.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.43 / $80.00 / $85.00
| Facility | | $22.43 | $80.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.03 / $55.03 / $82.88
| Professional | | $55.03 | $55.03 | $82.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.91 / $11.05 / $15.00
| Facility | | $7.91 | $11.05 | $15.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.64 / $5.64 / $12.10
| Professional | | $5.64 | $5.64 | $12.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.86 / $20.86 / $20.86
| Professional | | $20.86 | $20.86 | $20.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.77 / $8.55 / $10.11
| Professional | | $7.77 | $8.55 | $10.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.42 / $4.99 / $12.38
| Professional | | $4.42 | $4.99 | $12.38 |