- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.38 / $3.09 / $3.51
| Facility | | $2.38 | $3.09 | $3.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.20 / $3.14 / $4.18
| Professional | | $2.20 | $3.14 | $4.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.86 / $2.86 / $3.09
| Professional | | $2.86 | $2.86 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.71 / $5.36 / $13.42
| Facility | | $2.71 | $5.36 | $13.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $2.27 / $2.54
| Professional | | $2.27 | $2.27 | $2.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.98 / $3.82 / $5.90
| Professional | | $2.98 | $3.82 | $5.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.76 / $4.76 / $4.76
| Facility | | $4.76 | $4.76 | $4.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.86 / $2.86 / $3.03
| Facility | | $2.86 | $2.86 | $3.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.43 / $2.43 / $3.03
| Professional | | $2.43 | $2.43 | $3.03 |
- 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
- $26.50 / $27.56 / $35.78
| Professional | | $26.50 | $27.56 | $35.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.30 / $3.51 / $4.76
| Facility | | $1.30 | $3.51 | $4.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.92 / $4.29 / $4.76
| Professional | | $2.92 | $4.29 | $4.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.30 / $3.40 / $4.76
| Facility | | $1.30 | $3.40 | $4.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.43 / $2.43 / $3.97
| Professional | | $2.43 | $2.43 | $3.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.69 / $2.20 / $2.89
| Professional | | $1.69 | $2.20 | $2.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.38 / $2.38 / $4.76
| Professional | | $2.38 | $2.38 | $4.76 |