- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.08 / $7.08 / $7.08
| Facility | | $7.08 | $7.08 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $7.08 / $12.02
| Professional | | $5.01 | $7.08 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.14 / $15.14 / $25.12
| Facility | | $15.14 | $15.14 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $14.13 / $16.98
| Professional | | $10.72 | $14.13 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $35.48 / $74.13
| Facility | | $9.55 | $35.48 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $21.38 / $28.84
| Professional | | $7.08 | $21.38 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.41 / $12.30 / $18.62
| Facility | | $7.41 | $12.30 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $19.05 / $24.55
| Professional | | $13.49 | $19.05 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.59 / $14.79 / $79.43
| Facility | | $7.59 | $14.79 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.61 / $9.12 / $17.38
| Professional | | $6.61 | $9.12 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $58.88 / $70.79
| Professional | | $7.08 | $58.88 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $22.91 / $41.69
| Professional | | $15.14 | $22.91 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.55 / $30.20 / $81.28
| Facility | | $9.55 | $30.20 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $14.13 / $85.11
| Professional | | $7.08 | $14.13 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.71 / $10.00 / $21.88
| Facility | | $8.71 | $10.00 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.50 / $8.13 / $12.59
| Professional | | $5.50 | $8.13 | $12.59 |