- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.28 / $27.47 / $239.35
| Facility | | $3.28 | $27.47 | $239.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.39 / $1.41 / $2.42
| Professional | | $1.39 | $1.41 | $2.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.14 / $7.94 / $15.64
| Facility | | $3.14 | $7.94 | $15.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.19 / $3.19 / $7.82
| Professional | | $3.19 | $3.19 | $7.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.49 / $2.00 / $47.32
| Facility | | $1.49 | $2.00 | $47.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.25 / $21.25 / $21.25
| Facility | | $21.25 | $21.25 | $21.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.31 / $1.39 / $1.39
| Facility | | $1.31 | $1.39 | $1.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.39 / $1.39 / $1.39
| Professional | | $1.39 | $1.39 | $1.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.00 / $100.00 / $100.00
| Facility | | $85.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.41 / $2.04 / $28.03
| Facility | | $1.41 | $2.04 | $28.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.12 / $1.39 / $2.97
| Professional | | $1.12 | $1.39 | $2.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.94 / $747.03 / $2,207.00
| Facility | | $505.94 | $747.03 | $2,207.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.31 / $1.39 / $2.98
| Facility | | $1.31 | $1.39 | $2.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.22 / $1.39 / $2.34
| Professional | | $1.22 | $1.39 | $2.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.39 / $1.39 / $1.39
| Professional | | $1.39 | $1.39 | $1.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.49 / $1.64 / $1.88
| Professional | | $1.49 | $1.64 | $1.88 |