- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.84 / $1.89 / $2.69
| Facility | | $1.84 | $1.89 | $2.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.69 / $2.02 / $2.54
| Professional | | $1.69 | $2.02 | $2.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.10 / $2.10 / $2.10
| Professional | | $2.10 | $2.10 | $2.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.18 / $2.31 / $3.83
| Professional | | $2.18 | $2.31 | $3.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.61 / $2.61 / $2.61
| Facility | | $2.61 | $2.61 | $2.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.83 / $2.62 / $5.00
| Professional | | $1.83 | $2.62 | $5.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.94 / $3.99 / $89.00
| Professional | | $2.94 | $3.99 | $89.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $2.54 / $2.54
| Professional | | $2.40 | $2.54 | $2.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.80 / $2.10 / $4.70
| Facility | | $1.80 | $2.10 | $4.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.69 / $2.12 / $2.90
| Professional | | $1.69 | $2.12 | $2.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.79 / $2.37 / $2.92
| Professional | | $1.79 | $2.37 | $2.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.79 / $2.38 / $2.92
| Professional | | $1.79 | $2.38 | $2.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.61 / $2.61 / $2.61
| Facility | | $2.61 | $2.61 | $2.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.83 / $2.62 / $5.00
| Professional | | $1.83 | $2.62 | $5.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.20 / $2.20 / $2.27
| Facility | | $2.20 | $2.20 | $2.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.20 / $2.22 / $2.45
| Professional | | $2.20 | $2.22 | $2.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.72 / $65.93 / $81.86
| Facility | | $49.72 | $65.93 | $81.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.80 / $2.37 / $3.90
| Professional | | $1.80 | $2.37 | $3.90 |