- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.25 / $1.37 / $13.50
| Facility | | $1.25 | $1.37 | $13.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.37 / $2.11 / $13.50
| Professional | | $1.37 | $2.11 | $13.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.69 / $2.02 / $5.38
| Facility | | $1.69 | $2.02 | $5.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $2.34 / $5.18
| Professional | | $2.34 | $2.34 | $5.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.92 / $6.39 / $9.86
| Facility | | $4.92 | $6.39 | $9.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $10.05 / $17.63
| Professional | | $2.52 | $10.05 | $17.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $2.81 / $3.71
| Facility | | $2.81 | $2.81 | $3.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.39 / $2.39 / $3.14
| Professional | | $2.39 | $2.39 | $3.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.75 / $4.69 / $5.63
| Professional | | $3.75 | $4.69 | $5.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $3.28 / $7.27
| Professional | | $2.81 | $3.28 | $7.27 |
- 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
- $23.36 / $23.36 / $35.18
| Professional | | $23.36 | $23.36 | $35.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.61 / $9.61 / $9.61
| Professional | | $9.61 | $9.61 | $9.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.28 / $4.13 / $4.74
| Facility | | $1.28 | $4.13 | $4.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.39 / $2.81 / $4.26
| Professional | | $2.39 | $2.81 | $4.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.83 / $8.83 / $8.83
| Professional | | $8.83 | $8.83 | $8.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.75 / $5.49 / $7.13
| Professional | | $3.75 | $5.49 | $7.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $1.99 / $4.45
| Professional | | $1.78 | $1.99 | $4.45 |