- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.60 / $13.60 / $22.14
| Facility | | $6.60 | $13.60 | $22.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.12 / $6.60 / $7.77
| Professional | | $4.12 | $6.60 | $7.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.77 / $7.77 / $20.20
| Facility | | $7.77 | $7.77 | $20.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.84 / $4.66 / $17.60
| Professional | | $3.84 | $4.66 | $17.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.77 / $7.77 / $7.77
| Facility | | $7.77 | $7.77 | $7.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.67 / $7.77 / $7.77
| Professional | | $5.67 | $7.77 | $7.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.43 / $15.55 / $27.22
| Facility | | $5.43 | $15.55 | $27.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.08 / $4.08 / $37.45
| Professional | | $4.08 | $4.08 | $37.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.32 / $12.82 / $332.00
| Facility | | $9.32 | $12.82 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.11 / $4.58 / $14.53
| Professional | | $3.11 | $4.58 | $14.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.60 / $7.46 / $10.15
| Professional | | $6.60 | $7.46 | $10.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.31 / $16.53 / $106.03
| Facility | | $9.31 | $16.53 | $106.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.08 / $8.25 / $16.89
| Professional | | $4.08 | $8.25 | $16.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $4.66 / $11.66
| Professional | | $3.26 | $4.66 | $11.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.72 / $8.72 / $8.72
| Facility | | $8.72 | $8.72 | $8.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.81 / $8.63 / $10.15
| Professional | | $6.81 | $8.63 | $10.15 |