- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.99 / $3.37 / $6.50
| Facility | | $2.99 | $3.37 | $6.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.88 / $3.37 / $6.50
| Professional | | $1.88 | $3.37 | $6.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.11 / $3.11 / $9.49
| Professional | | $3.11 | $3.11 | $9.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.33 / $5.73 / $5.73
| Facility | | $5.33 | $5.73 | $5.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.73 / $5.73 / $5.73
| Professional | | $5.73 | $5.73 | $5.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.15 / $4.13 / $4.13
| Facility | | $3.15 | $4.13 | $4.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.51 / $3.51 / $4.86
| Professional | | $3.51 | $3.51 | $4.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.87 / $15.46 / $332.00
| Facility | | $6.87 | $15.46 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.55 / $5.15 / $12.57
| Professional | | $3.55 | $5.15 | $12.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.37 / $1.37 / $1.37
| Facility | | $1.37 | $1.37 | $1.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.37 / $3.98 / $4.93
| Professional | | $1.37 | $3.98 | $4.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.15 / $4.13 / $555.00
| Facility | | $3.15 | $4.13 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.51 / $4.13 / $9.84
| Professional | | $3.51 | $4.13 | $9.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.29 / $3.65 / $6.29
| Professional | | $2.29 | $3.65 | $6.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.98 / $3.98 / $4.93
| Facility | | $3.98 | $3.98 | $4.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.37 / $3.98 / $4.23
| Professional | | $1.37 | $3.98 | $4.23 |