- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.18 / $5.50 / $6.82
| Facility | | $4.18 | $5.50 | $6.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.18 / $5.50 / $7.33
| Professional | | $4.18 | $5.50 | $7.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.32 / $5.32 / $5.32
| Professional | | $5.32 | $5.32 | $5.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.79 / $10.23 / $23.59
| Facility | | $4.79 | $10.23 | $23.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.99 / $3.99 / $4.47
| Professional | | $3.99 | $3.99 | $4.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.38 / $8.38 / $8.38
| Facility | | $8.38 | $8.38 | $8.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.54 / $5.03 / $5.33
| Facility | | $4.54 | $5.03 | $5.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.28 / $4.28 / $5.33
| Professional | | $4.28 | $4.28 | $5.33 |
- 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
- $41.73 / $41.73 / $62.85
| Professional | | $41.73 | $41.73 | $62.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.29 / $6.16 / $8.38
| Facility | | $2.29 | $6.16 | $8.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.13 / $7.54 / $8.38
| Professional | | $5.13 | $7.54 | $8.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.29 / $6.00 / $8.38
| Facility | | $2.29 | $6.00 | $8.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.28 / $4.28 / $6.96
| Professional | | $4.28 | $4.28 | $6.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.96 / $3.86 / $5.09
| Professional | | $2.96 | $3.86 | $5.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.20 / $4.20 / $8.38
| Professional | | $4.20 | $4.20 | $8.38 |