- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.75 / $16.72 / $54.68
| Facility | | $4.75 | $16.72 | $54.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.68 / $15.85 / $21.56
| Professional | | $15.68 | $15.85 | $21.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.55 / $4.15 / $8.83
| Facility | | $1.55 | $4.15 | $8.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $2.00
| Professional | | $2.00 | $2.00 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.58 / $8.35 / $35.29
| Facility | | $2.58 | $8.35 | $35.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.81 / $15.69 / $15.69
| Facility | | $14.81 | $15.69 | $15.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.69 / $15.69 / $15.69
| Professional | | $15.69 | $15.69 | $15.69 |
- 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
- $2.63 / $17.45 / $37.28
| Facility | | $2.63 | $17.45 | $37.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.77 / $14.98 / $28.73
| Professional | | $11.77 | $14.98 | $28.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.43 / $1,453.03 / $3,582.67
| Facility | | $302.43 | $1,453.03 | $3,582.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.41 / $15.69 / $22.44
| Facility | | $2.41 | $15.69 | $22.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.60 / $15.69 / $17.03
| Professional | | $12.60 | $15.69 | $17.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.69 / $15.69 / $15.69
| Professional | | $15.69 | $15.69 | $15.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.96 / $6.96 / $21.18
| Professional | | $6.96 | $6.96 | $21.18 |