- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.92 / $8.42 / $14.21
| Facility | | $5.92 | $8.42 | $14.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.81 / $8.15 / $9.05
| Professional | | $6.81 | $8.15 | $9.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.19 / $8.19 / $8.19
| Professional | | $8.19 | $8.19 | $8.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.58 / $109.22 / $227.88
| Facility | | $45.58 | $109.22 | $227.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.18 / $5.18 / $5.18
| Professional | | $5.18 | $5.18 | $5.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.15 / $36.29 / $53.52
| Professional | | $5.15 | $36.29 | $53.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.39 / $7.39 / $80.00
| Facility | | $7.39 | $7.39 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.69 / $8.15 / $8.15
| Facility | | $7.69 | $8.15 | $8.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.15 / $8.15 / $8.46
| Professional | | $8.15 | $8.15 | $8.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.44 / $547.94 / $608.45
| Facility | | $81.44 | $547.94 | $608.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,072.56 / $7,072.56 / $7,072.56
| Professional | | $7,072.56 | $7,072.56 | $7,072.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.86 / $8.56 / $46.93
| Facility | | $5.86 | $8.56 | $46.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.15 / $8.31 / $13.45
| Professional | | $8.15 | $8.31 | $13.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.66 / $8.97 / $72.20
| Professional | | $7.66 | $8.97 | $72.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.15 / $8.56 / $47.13
| Facility | | $8.15 | $8.56 | $47.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.15 / $8.15 / $16.13
| Professional | | $8.15 | $8.15 | $16.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.15 / $8.64 / $9.36
| Professional | | $8.15 | $8.64 | $9.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.68 / $8.15 / $11.41
| Professional | | $4.68 | $8.15 | $11.41 |