- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.40 / $1.85 / $1.99
| Facility | | $1.40 | $1.85 | $1.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.20 / $1.85 / $2.46
| Professional | | $1.20 | $1.85 | $2.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.13 / $3.16 / $7.72
| Facility | | $2.13 | $3.16 | $7.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.34 / $1.34 / $1.34
| Professional | | $1.34 | $1.34 | $1.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.11 / $2.11 / $2.11
| Professional | | $2.11 | $2.11 | $2.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $30.20
| Facility | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.69 / $1.69 / $3.29
| Facility | | $1.69 | $1.69 | $3.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.44 / $1.44 / $1.44
| Professional | | $1.44 | $1.44 | $1.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.70 / $80.00 / $85.00
| Facility | | $5.70 | $80.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.99 / $13.99 / $21.08
| Professional | | $13.99 | $13.99 | $21.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.85 / $2.27 / $3.61
| Facility | | $1.85 | $2.27 | $3.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.39 / $2.67 / $2.81
| Professional | | $2.39 | $2.67 | $2.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.50 / $4.00 / $5.50
| Professional | | $3.50 | $4.00 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.85 / $2.33 / $3.94
| Facility | | $1.85 | $2.33 | $3.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.44 / $1.44 / $2.34
| Professional | | $1.44 | $1.44 | $2.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $1.30 / $1.72
| Professional | | $1.00 | $1.30 | $1.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.27 / $2.81 / $3.79
| Professional | | $1.27 | $2.81 | $3.79 |