- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.71 / $6.07 / $148.72
| Facility | | $1.71 | $6.07 | $148.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.71 / $1.73 / $6.07
| Professional | | $1.71 | $1.73 | $6.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.54 / $1.88 / $2.46
| Facility | | $1.54 | $1.88 | $2.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.71 / $1.74 / $6.11
| Professional | | $1.71 | $1.74 | $6.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.16 / $4.16 / $4.16
| Facility | | $4.16 | $4.16 | $4.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.58 / $1.76 / $4.95
| Professional | | $1.58 | $1.76 | $4.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.61 / $1.61 / $1.71
| Facility | | $1.61 | $1.61 | $1.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.71 / $1.71 / $2.67
| Professional | | $1.71 | $1.71 | $2.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.79 / $1.81 / $2.42
| Professional | | $1.79 | $1.81 | $2.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.54 / $1.97 / $3.73
| Professional | | $1.54 | $1.97 | $3.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.00 / $100.00 / $100.00
| Facility | | $85.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.56 / $8.56 / $8.56
| Professional | | $8.56 | $8.56 | $8.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.66 / $3.66 / $3.66
| Professional | | $3.66 | $3.66 | $3.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.61 / $1.71 / $3.36
| Facility | | $1.61 | $1.71 | $3.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.71 / $1.71 / $2.67
| Professional | | $1.71 | $1.71 | $2.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.97 / $3.97 / $3.97
| Professional | | $3.97 | $3.97 | $3.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.37 / $1.88 / $3.08
| Professional | | $1.37 | $1.88 | $3.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.71 / $1.71 / $4.28
| Professional | | $1.71 | $1.71 | $4.28 |