- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.51 / $3.02 / $3.02
| Facility | | $2.51 | $3.02 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.02 / $3.98
| Professional | | $2.00 | $3.02 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.63 / $2.88 / $3.09
| Professional | | $2.63 | $2.88 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.98 / $5.62 / $13.80
| Facility | | $3.98 | $5.62 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $2.40 / $2.40
| Professional | | $2.40 | $2.40 | $2.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $4.07 / $6.17
| Professional | | $3.02 | $4.07 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.13 / $5.13 / $79.43
| Facility | | $5.13 | $5.13 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.02 / $3.02 / $3.16
| Facility | | $3.02 | $3.02 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $2.57 / $3.02
| Professional | | $2.57 | $2.57 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $85.11 / $85.11
| Facility | | $79.43 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $37.15 / $37.15
| Professional | | $25.12 | $37.15 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.63 / $4.27 / $7.08
| Facility | | $2.63 | $4.27 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.70 / $3.02 / $4.79
| Professional | | $1.70 | $3.02 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.82 / $2.82 / $81.28
| Professional | | $2.82 | $2.82 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.51 / $4.07 / $7.41
| Facility | | $2.51 | $4.07 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $2.57 / $3.39
| Professional | | $2.57 | $2.57 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.38 / $1.95 / $2.34
| Facility | | $1.38 | $1.95 | $2.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $2.29 / $3.02
| Professional | | $1.78 | $2.29 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.13 / $5.13 / $5.13
| Professional | | $5.13 | $5.13 | $5.13 |