- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.93 / $6.48 / $167.92
| Facility | | $2.93 | $6.48 | $167.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.06 / $10.56
| Professional | | $2.04 | $2.06 | $10.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.42 / $2.84 / $1,023.29
| Facility | | $2.42 | $2.84 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.88 / $2.21 / $8,639.91
| Facility | | $1.88 | $2.21 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.11 / $2.11
| Professional | | $2.11 | $2.11 | $2.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.92 / $2.04 / $2.04
| Facility | | $1.92 | $2.04 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.04 / $2.04
| Professional | | $2.04 | $2.04 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.40 / $107.11 / $158.30
| Facility | | $14.40 | $107.11 | $158.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.42 / $2.76 / $982.48
| Facility | | $2.42 | $2.76 | $982.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.00 / $6.89 / $128.69
| Facility | | $3.00 | $6.89 | $128.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.64 / $7.93
| Professional | | $2.04 | $2.64 | $7.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.92 / $2.04 / $2.04
| Facility | | $1.92 | $2.04 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.04 / $2.04
| Professional | | $2.04 | $2.04 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.57 / $2.57 / $2.98
| Facility | | $2.57 | $2.57 | $2.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $2.57 / $2.98
| Professional | | $2.57 | $2.57 | $2.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.04 / $3.73
| Professional | | $2.04 | $2.04 | $3.73 |