- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.21 / $4.21 / $4.54
| Facility | | $4.21 | $4.21 | $4.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.81 / $4.54 / $8.41
| Professional | | $3.81 | $4.54 | $8.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.72 / $6.82 / $7.21
| Professional | | $5.72 | $6.82 | $7.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,456.92 / $5,821.21 / $8,577.84
| Facility | | $5,456.92 | $5,821.21 | $8,577.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.57 / $4.57 / $5.72
| Professional | | $4.57 | $4.57 | $5.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.73 / $7.21 / $9.61
| Professional | | $6.73 | $7.21 | $9.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.61 / $50.46 / $50.46
| Facility | | $9.61 | $50.46 | $50.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.18 / $5.18 / $5.18
| Facility | | $5.18 | $5.18 | $5.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.78 / $3.78 / $5.18
| Professional | | $3.78 | $3.78 | $5.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.19 / $53.19 / $60.08
| Professional | | $53.19 | $53.19 | $60.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.58 / $6.71 / $9.61
| Facility | | $2.58 | $6.71 | $9.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.61 / $8.01 / $9.61
| Professional | | $2.61 | $8.01 | $9.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.10 / $3.10 / $3.10
| Professional | | $3.10 | $3.10 | $3.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.58 / $6.43 / $9.61
| Facility | | $2.58 | $6.43 | $9.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.78 / $3.78 / $5.52
| Professional | | $3.78 | $3.78 | $5.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.33 / $4.93 / $6.16
| Professional | | $3.33 | $4.93 | $6.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.84 / $4.86 / $9.61
| Professional | | $4.84 | $4.86 | $9.61 |