- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.38 / $3.13 / $3.38
| Facility | | $2.38 | $3.13 | $3.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $3.13 / $4.17
| Professional | | $2.06 | $3.13 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.68 / $5.86 / $13.07
| Facility | | $3.68 | $5.86 | $13.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $2.54 / $2.54
| Professional | | $2.54 | $2.54 | $2.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.58 / $5.58 / $5.58
| Facility | | $5.58 | $5.58 | $5.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.94 / $1.94 / $1.94
| Professional | | $1.94 | $1.94 | $1.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.66 / $80.00 / $85.00
| Facility | | $9.66 | $80.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.70 / $23.70 / $35.70
| Professional | | $23.70 | $23.70 | $35.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.13 / $3.72 / $5.94
| Facility | | $3.13 | $3.72 | $5.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $4.51 / $4.76
| Professional | | $4.05 | $4.51 | $4.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.76 / $5.90 / $9.40
| Professional | | $4.76 | $5.90 | $9.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.13 / $3.73 / $6.08
| Facility | | $3.13 | $3.73 | $6.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.94 / $1.94 / $3.96
| Professional | | $1.94 | $1.94 | $3.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.69 / $2.19 / $2.88
| Professional | | $1.69 | $2.19 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.82 / $4.76 / $6.43
| Professional | | $1.82 | $4.76 | $6.43 |