- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.05 / $14.67 / $87.19
| Facility | | $4.05 | $14.67 | $87.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.20 / $2.23 / $3.74
| Professional | | $2.20 | $2.23 | $3.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.40 / $3.81 / $8.22
| Facility | | $1.40 | $3.81 | $8.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.92 / $1.92 / $1.92
| Professional | | $1.92 | $1.92 | $1.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.67 / $5.90 / $8.44
| Facility | | $1.67 | $5.90 | $8.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.62 / $2.62 / $2.62
| Professional | | $2.62 | $2.62 | $2.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.18 / $10.18 / $10.18
| Facility | | $10.18 | $10.18 | $10.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.08 / $2.21 / $2.21
| Facility | | $2.08 | $2.21 | $2.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.21 / $2.21 / $2.21
| Professional | | $2.21 | $2.21 | $2.21 |
- 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
- $1.48 / $3.93 / $37.45
| Facility | | $1.48 | $3.93 | $37.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.97 / $2.21 / $4.47
| Professional | | $1.97 | $2.21 | $4.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.58 / $2.21 / $3.16
| Facility | | $1.58 | $2.21 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $2.21 / $4.09
| Professional | | $2.14 | $2.21 | $4.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.21 / $2.21 / $2.21
| Professional | | $2.21 | $2.21 | $2.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $2.47 / $2.98
| Professional | | $2.47 | $2.47 | $2.98 |