- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.57 / $1.76 / $3.42
| Facility | | $1.57 | $1.76 | $3.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.98 / $1.76 / $3.42
| Professional | | $0.98 | $1.76 | $3.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $2.06 / $2.06
| Professional | | $2.06 | $2.06 | $2.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.81 / $2.02 / $4.75
| Professional | | $1.81 | $2.02 | $4.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $3.02 / $3.02
| Facility | | $2.81 | $3.02 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $3.02 / $3.02
| Professional | | $3.02 | $3.02 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.18 / $2.18 / $2.29
| Facility | | $2.18 | $2.18 | $2.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $1.85 / $2.56
| Professional | | $1.85 | $1.85 | $2.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.62 / $8.15 / $332.00
| Facility | | $3.62 | $8.15 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.84 / $2.61 / $6.41
| Professional | | $1.84 | $2.61 | $6.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.74 / $2.74 / $2.74
| Facility | | $2.74 | $2.74 | $2.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.61 / $2.61 / $3.02
| Professional | | $2.61 | $2.61 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.59 / $2.59 / $2.59
| Professional | | $2.59 | $2.59 | $2.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.65 / $2.65 / $2.65
| Professional | | $2.65 | $2.65 | $2.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.18 / $2.18 / $555.00
| Facility | | $2.18 | $2.18 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.85 / $2.22 / $5.16
| Professional | | $1.85 | $2.22 | $5.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.20 / $1.81 / $3.09
| Professional | | $1.20 | $1.81 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.58 / $2.61 / $2.61
| Facility | | $2.58 | $2.61 | $2.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.61 / $2.61 / $2.74
| Professional | | $2.61 | $2.61 | $2.74 |