- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.86 / $36.90 / $474.10
| Facility | | $4.86 | $36.90 | $474.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.50 / $6.13
| Professional | | $2.41 | $2.50 | $6.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.21 / $2.68 / $3.47
| Facility | | $2.21 | $2.68 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.46 / $8.16
| Professional | | $2.41 | $2.46 | $8.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.30 / $9.03 / $15.95
| Facility | | $5.30 | $9.03 | $15.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.61 / $2.61 / $7.42
| Professional | | $2.61 | $2.61 | $7.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.27 / $2.27 / $2.41
| Facility | | $2.27 | $2.27 | $2.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $2.41
| Professional | | $2.41 | $2.41 | $2.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.17 / $2.89 / $5.54
| Professional | | $2.17 | $2.89 | $5.54 |
- 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
- $2.27 / $2.41 / $3.45
| Facility | | $2.27 | $2.41 | $3.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $5.21
| Professional | | $2.41 | $2.41 | $5.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.16 / $4.16 / $4.16
| Professional | | $4.16 | $4.16 | $4.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.93 / $2.65 / $4.09
| Professional | | $1.93 | $2.65 | $4.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $5.30
| Professional | | $2.41 | $2.41 | $5.30 |