- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.74 / $2.25 / $2.43
| Facility | | $1.74 | $2.25 | $2.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.45 / $2.25 / $2.95
| Professional | | $1.45 | $2.25 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $3.13 / $7.51
| Facility | | $2.81 | $3.13 | $7.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.67 / $1.67 / $1.67
| Professional | | $1.67 | $1.67 | $1.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $2.54 / $2.54
| Professional | | $1.86 | $2.54 | $2.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.36 / $2.36 / $3.94
| Facility | | $2.36 | $2.36 | $3.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $2.00
| Professional | | $2.00 | $2.00 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.68 / $75.00 / $75.00
| Facility | | $5.68 | $75.00 | $75.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.82 / $16.82 / $25.35
| Professional | | $16.82 | $16.82 | $25.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.25 / $3.38 / $6.06
| Facility | | $2.25 | $3.38 | $6.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.87 / $3.21 / $3.38
| Professional | | $2.87 | $3.21 | $3.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.80 / $6.80 / $6.80
| Professional | | $6.80 | $6.80 | $6.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.25 / $3.38 / $6.21
| Facility | | $2.25 | $3.38 | $6.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $7.80
| Professional | | $2.00 | $2.00 | $7.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $1.56 / $2.60
| Professional | | $1.42 | $1.56 | $2.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.72 / $3.38 / $4.55
| Professional | | $1.72 | $3.38 | $4.55 |