- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.08 / $10.00 / $14.45
| Facility | | $7.08 | $10.00 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $4.79 / $14.45
| Professional | | $3.98 | $4.79 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.13 / $6.31 / $12.59
| Facility | | $5.13 | $6.31 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $6.03 / $22.91
| Professional | | $5.75 | $6.03 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.45 / $18.20 / $28.84
| Facility | | $14.45 | $18.20 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.79 / $6.17 / $22.39
| Professional | | $4.79 | $6.17 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.47 / $4.47 / $4.79
| Facility | | $4.47 | $4.47 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.79 / $4.79 / $4.79
| Professional | | $4.79 | $4.79 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.27 / $5.25 / $10.96
| Professional | | $4.27 | $5.25 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $645.65
| Facility | | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.17 / $6.17 / $6.17
| Professional | | $6.17 | $6.17 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.80 / $6.76 / $10.47
| Facility | | $3.80 | $6.76 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.72 / $3.72 / $4.47
| Professional | | $3.72 | $3.72 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.95 / $4.07 / $6.31
| Professional | | $2.95 | $4.07 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.79 / $57.54 / $57.54
| Facility | | $4.79 | $57.54 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.79 / $4.79 / $13.18
| Professional | | $4.79 | $4.79 | $13.18 |