- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.54 / $2.00 / $2.27
| Facility | | $1.54 | $2.00 | $2.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.52 / $2.02 / $2.71
| Professional | | $1.52 | $2.02 | $2.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.86 / $1.86 / $1.86
| Professional | | $1.86 | $1.86 | $1.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.96 / $3.42 / $8.64
| Facility | | $1.96 | $3.42 | $8.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.48 / $1.48 / $1.65
| Professional | | $1.48 | $1.48 | $1.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.93 / $2.48 / $3.10
| Professional | | $1.93 | $2.48 | $3.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.10 / $3.10 / $3.10
| Facility | | $3.10 | $3.10 | $3.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.85 / $1.85 / $2.29
| Facility | | $1.85 | $1.85 | $2.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.57 / $1.57 / $1.85
| Professional | | $1.57 | $1.57 | $1.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.64 / $18.05 / $23.25
| Professional | | $17.64 | $18.05 | $23.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.84 / $2.27 / $3.10
| Facility | | $0.84 | $2.27 | $3.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.90 / $2.79 / $3.10
| Professional | | $1.90 | $2.79 | $3.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.84 / $2.20 / $3.10
| Facility | | $0.84 | $2.20 | $3.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.57 / $1.57 / $2.71
| Professional | | $1.57 | $1.57 | $2.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.09 / $1.42 / $1.87
| Professional | | $1.09 | $1.42 | $1.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.39 / $1.39 / $3.10
| Professional | | $1.39 | $1.39 | $3.10 |