- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.43 / $264.77 / $760.79
| Facility | | $3.43 | $264.77 | $760.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.62 / $3.52 / $3.70
| Professional | | $2.62 | $3.52 | $3.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.28 / $8.30 / $16.39
| Facility | | $3.28 | $8.30 | $16.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.73 / $0.73 / $15.05
| Facility | | $0.73 | $0.73 | $15.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.28 / $101.28 / $101.28
| Facility | | $101.28 | $101.28 | $101.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.62 / $2.62 / $2.62
| Facility | | $2.62 | $2.62 | $2.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.62 / $2.62 / $2.62
| Professional | | $2.62 | $2.62 | $2.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $100.00 / $100.00
| Facility | | $75.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.52 / $3.28 / $7.38
| Facility | | $0.52 | $3.28 | $7.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $2.46 / $4.70
| Professional | | $2.45 | $2.46 | $4.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.50 / $2.62 / $5.03
| Facility | | $1.50 | $2.62 | $5.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.46 / $2.62 / $3.88
| Professional | | $2.46 | $2.62 | $3.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.67 / $12.67 / $12.67
| Facility | | $12.67 | $12.67 | $12.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $2.57 / $2.57
| Professional | | $2.57 | $2.57 | $2.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.58 / $3.58 / $4.83
| Professional | | $3.58 | $3.58 | $4.83 |