- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.96 / $15.69 / $212.42
| Facility | | $2.96 | $15.69 | $212.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.90 / $2.93 / $3.24
| Professional | | $2.90 | $2.93 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.35 / $3.74 / $7.61
| Facility | | $1.35 | $3.74 | $7.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.35 / $1.35 / $1.35
| Professional | | $1.35 | $1.35 | $1.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.85 / $6.85 / $7.20
| Facility | | $6.85 | $6.85 | $7.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.00 / $24.00 / $24.00
| Facility | | $24.00 | $24.00 | $24.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.73 / $2.90 / $2.90
| Facility | | $2.73 | $2.90 | $2.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.90 / $2.90 / $2.90
| Professional | | $2.90 | $2.90 | $2.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $100.00 / $100.00
| Facility | | $75.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.29 / $4.26 / $25.20
| Facility | | $2.29 | $4.26 | $25.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.50 / $2.75 / $5.27
| Professional | | $1.50 | $2.75 | $5.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.75 / $2.90 / $4.26
| Facility | | $1.75 | $2.90 | $4.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.74 / $2.90 / $3.14
| Professional | | $1.74 | $2.90 | $3.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.56 / $3.47 / $3.47
| Facility | | $2.56 | $3.47 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.90 / $2.90 / $2.90
| Professional | | $2.90 | $2.90 | $2.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.83 / $0.83 / $3.92
| Professional | | $0.83 | $0.83 | $3.92 |