- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.57 / $1.57 / $1.72
| Facility | | $1.57 | $1.57 | $1.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.72 / $2.56 / $4.84
| Professional | | $1.72 | $2.56 | $4.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.11 / $2.54 / $6.72
| Facility | | $2.11 | $2.54 | $6.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.93 / $2.93 / $5.46
| Professional | | $2.93 | $2.93 | $5.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.17 / $8.01 / $12.38
| Facility | | $6.17 | $8.01 | $12.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.17 / $12.57 / $22.06
| Professional | | $3.17 | $12.57 | $22.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.34 / $3.77 / $4.18
| Facility | | $3.34 | $3.77 | $4.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $3.20 / $3.77
| Professional | | $2.40 | $3.20 | $3.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.70 / $5.87 / $7.04
| Professional | | $4.70 | $5.87 | $7.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.52 / $4.11 / $9.10
| Professional | | $3.52 | $4.11 | $9.10 |
- 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
- $29.23 / $29.23 / $44.03
| Professional | | $29.23 | $29.23 | $44.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.03 / $12.03 / $12.03
| Professional | | $12.03 | $12.03 | $12.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.60 / $5.18 / $5.93
| Facility | | $1.60 | $5.18 | $5.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $3.20 / $4.99
| Professional | | $2.40 | $3.20 | $4.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.05 / $11.05 / $11.05
| Professional | | $11.05 | $11.05 | $11.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.70 / $4.70 / $4.70
| Professional | | $4.70 | $4.70 | $4.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.23 / $2.48 / $5.75
| Professional | | $2.23 | $2.48 | $5.75 |