- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.49 / $2.92 / $547.61
| Facility | | $1.49 | $2.92 | $547.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.60 / $1.86 / $2.20
| Professional | | $1.60 | $1.86 | $2.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.33 / $1.36 / $1.86
| Professional | | $1.33 | $1.36 | $1.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.44 / $17.35 / $34.27
| Facility | | $6.44 | $17.35 | $34.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.41 / $7.41 / $7.41
| Professional | | $7.41 | $7.41 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.33 / $2.00 / $20.16
| Facility | | $1.33 | $2.00 | $20.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.66 / $1.66 / $2.14
| Professional | | $1.66 | $1.66 | $2.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.70 / $1.70 / $80.00
| Facility | | $1.70 | $1.70 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.75 / $1.86 / $1.86
| Facility | | $1.75 | $1.86 | $1.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $1.86 / $1.86
| Professional | | $1.86 | $1.86 | $1.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $979.65 / $979.65
| Facility | | $75.00 | $979.65 | $979.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.29 / $179.29 / $179.29
| Professional | | $179.29 | $179.29 | $179.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.33 / $2.35 / $20.92
| Facility | | $1.33 | $2.35 | $20.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $1.90 / $3.07
| Professional | | $1.86 | $1.90 | $3.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.75 / $2.04 / $6.80
| Professional | | $1.75 | $2.04 | $6.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.86 / $2.16 / $20.92
| Facility | | $1.86 | $2.16 | $20.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $1.86 / $2.36
| Professional | | $1.86 | $1.86 | $2.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $1.97 / $2.08
| Professional | | $1.86 | $1.97 | $2.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.33 / $1.86 / $2.60
| Professional | | $1.33 | $1.86 | $2.60 |