- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.34 / $3.03 / $3.44
| Facility | | $2.34 | $3.03 | $3.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $3.08 / $4.09
| Professional | | $2.34 | $3.08 | $4.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.81 / $2.81 / $2.81
| Professional | | $2.81 | $2.81 | $2.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.46 / $2.67 / $2.98
| Facility | | $2.46 | $2.67 | $2.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.23 / $2.23 / $2.50
| Professional | | $2.23 | $2.23 | $2.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.92 / $3.75 / $5.79
| Professional | | $2.92 | $3.75 | $5.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.69 / $4.69 / $4.69
| Facility | | $4.69 | $4.69 | $4.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.81 / $2.81 / $3.06
| Facility | | $2.81 | $2.81 | $3.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.39 / $2.39 / $2.98
| Professional | | $2.39 | $2.39 | $2.98 |
- 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
- Facility
- Modifier
- Low / Median / High Price
- $1.28 / $3.44 / $4.69
| Facility | | $1.28 | $3.44 | $4.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.87 / $4.22 / $4.69
| Professional | | $2.87 | $4.22 | $4.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.28 / $3.34 / $4.69
| Facility | | $1.28 | $3.34 | $4.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.39 / $2.39 / $3.89
| Professional | | $2.39 | $2.39 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.66 / $2.15 / $2.84
| Professional | | $1.66 | $2.15 | $2.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $2.34 / $4.69
| Professional | | $2.34 | $2.34 | $4.69 |