- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.58 / $1.86 / $2.29
| Facility | | $1.58 | $1.86 | $2.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $2.00 / $3.39
| Professional | | $1.00 | $2.00 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $2.29 / $3.89
| Professional | | $2.14 | $2.29 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.63 / $3.63 / $3.63
| Facility | | $3.63 | $3.63 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.95 / $2.69 / $5.01
| Professional | | $1.95 | $2.69 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.69 / $3.63 / $4.68
| Professional | | $2.69 | $3.63 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.04 / $2.04 / $2.14
| Facility | | $2.04 | $2.04 | $2.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.70 / $2.34 / $5.01
| Professional | | $1.70 | $2.34 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $2.51 / $2.51
| Professional | | $2.40 | $2.51 | $2.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.58 / $1.86 / $2.40
| Facility | | $1.58 | $1.86 | $2.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $2.00 / $4.37
| Professional | | $1.00 | $2.00 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $2.34 / $2.95
| Professional | | $1.78 | $2.34 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $2.40 / $3.09
| Professional | | $1.86 | $2.40 | $3.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.70 / $2.29 / $5.25
| Professional | | $1.70 | $2.29 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $77.62 / $95.50
| Facility | | $51.29 | $77.62 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $2.34 / $3.89
| Professional | | $1.78 | $2.34 | $3.89 |