- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.70 / $2,017.43 / $4,312.50
| Facility | | $6.70 | $2,017.43 | $4,312.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.69 / $892.64 / $3,100.81
| Professional | | $6.69 | $892.64 | $3,100.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.13 / $12.03 / $14.50
| Facility | | $8.13 | $12.03 | $14.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $6.50 / $8.25
| Professional | | $6.50 | $6.50 | $8.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.90 / $8.90 / $10.40
| Facility | | $8.90 | $8.90 | $10.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.25 / $15.55 / $22.22
| Facility | | $6.25 | $15.55 | $22.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.60 / $9.86 / $11.21
| Professional | | $6.60 | $9.86 | $11.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.63 / $6.50 / $6.50
| Facility | | $5.63 | $6.50 | $6.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.74 / $13.00 / $13.00
| Professional | | $3.74 | $13.00 | $13.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.71 / $10.59 / $14.60
| Facility | | $5.71 | $10.59 | $14.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $6.50 / $13.00
| Professional | | $6.50 | $6.50 | $13.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.48 / $65.00 / $85.00
| Professional | | $6.48 | $65.00 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.63 / $6.50 / $6.50
| Facility | | $5.63 | $6.50 | $6.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.74 / $13.00 / $13.00
| Professional | | $3.74 | $13.00 | $13.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $10.03 / $20.00
| Professional | | $6.50 | $10.03 | $20.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,713.23 / $1,713.23 / $1,713.23
| Facility | | $1,713.23 | $1,713.23 | $1,713.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.25 / $6.25 / $6.25
| Professional | | $6.25 | $6.25 | $6.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.67 / $9.13 / $9.69
| Professional | | $7.67 | $9.13 | $9.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.50 / $6.50 / $8.44
| Professional | | $6.50 | $6.50 | $8.44 |