- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.15 / $4.59 / $6.36
| Facility | | $3.15 | $4.59 | $6.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.25 / $3.29 / $4.28
| Professional | | $3.25 | $3.29 | $4.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.13 / $7.69 / $15.35
| Facility | | $3.13 | $7.69 | $15.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.13 / $4.13 / $4.13
| Professional | | $4.13 | $4.13 | $4.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.67 / $3.39 / $213.23
| Facility | | $2.67 | $3.39 | $213.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.39 / $3.39 / $3.39
| Professional | | $3.39 | $3.39 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.44 / $148.44 / $148.44
| Facility | | $148.44 | $148.44 | $148.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.08 / $3.26 / $3.26
| Facility | | $3.08 | $3.26 | $3.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.26 / $3.26
| Professional | | $3.26 | $3.26 | $3.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $85.00 / $85.00
| Facility | | $75.00 | $85.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.24 / $13.24 / $13.24
| Professional | | $13.24 | $13.24 | $13.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.12 / $3.26 / $5.97
| Facility | | $3.12 | $3.26 | $5.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.06 / $3.33 / $5.38
| Professional | | $3.06 | $3.33 | $5.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.61 / $6.40
| Professional | | $3.26 | $3.61 | $6.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.26 / $3.26 / $6.12
| Facility | | $3.26 | $3.26 | $6.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.26 / $3.75
| Professional | | $3.26 | $3.26 | $3.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.46 / $3.68
| Professional | | $3.26 | $3.46 | $3.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $3.26 / $4.55
| Professional | | $3.00 | $3.26 | $4.55 |