- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.48 / $1.48 / $1.83
| Facility | | $1.48 | $1.48 | $1.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.60 / $1.48 / $1.57
| Professional | | $0.60 | $1.48 | $1.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.53 / $2.25 / $3.09
| Facility | | $1.53 | $2.25 | $3.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.18 / $1.27 / $1.40
| Professional | | $1.18 | $1.27 | $1.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.02 / $1.02 / $1.02
| Professional | | $1.02 | $1.02 | $1.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.28 / $1.83 / $2.50
| Facility | | $1.28 | $1.83 | $2.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $1.28 / $2.90
| Professional | | $1.00 | $1.28 | $2.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.40 / $2.70 / $3.80
| Professional | | $1.40 | $2.70 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.67 / $0.85 / $1.35
| Professional | | $0.67 | $0.85 | $1.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.43 / $80.00 / $85.00
| Facility | | $3.43 | $80.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.03 / $10.03 / $12.68
| Professional | | $10.03 | $10.03 | $12.68 |