- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.63 / $3.70 / $3.86
| Facility | | $1.63 | $3.70 | $3.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.24 / $1.63 / $2.82
| Professional | | $1.24 | $1.63 | $2.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.52 / $80.00 / $80.00
| Facility | | $2.52 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.57 / $14.34
| Professional | | $2.04 | $2.57 | $14.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.73 / $1.73 / $1.73
| Facility | | $1.73 | $1.73 | $1.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.47 / $1.47 / $2.14
| Professional | | $1.47 | $1.47 | $2.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.12 / $2.88 / $4.94
| Facility | | $2.12 | $2.88 | $4.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.12 / $3.05 / $4.96
| Professional | | $2.12 | $3.05 | $4.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.98 / $2.21 / $2.43
| Professional | | $1.98 | $2.21 | $2.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.59 / $2.81 / $2.88
| Facility | | $2.59 | $2.81 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.52 / $2.88 / $2.88
| Professional | | $2.52 | $2.88 | $2.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.39 / $2.52 / $4.66
| Facility | | $2.39 | $2.52 | $4.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.39 / $2.73 / $4.13
| Professional | | $2.39 | $2.73 | $4.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.29 / $2.45 / $3.17
| Professional | | $2.29 | $2.45 | $3.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.12 / $1.31 / $2.33
| Professional | | $1.12 | $1.31 | $2.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.45 / $1.78 / $1.78
| Professional | | $1.45 | $1.78 | $1.78 |