- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $10.96 / $10.96
| Facility | | $10.96 | $10.96 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $1.00 / $10.96
| Professional | | $1.00 | $1.00 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.93 / $1.20 / $2.95
| Facility | | $0.93 | $1.20 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.26 / $1.32 / $2.75
| Professional | | $1.26 | $1.32 | $2.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.63 / $3.63 / $5.37
| Facility | | $2.63 | $3.63 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.82 / $4.68 / $9.12
| Professional | | $2.82 | $4.68 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.51 / $1.51 / $1.78
| Facility | | $1.51 | $1.51 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.29 / $1.29 / $1.58
| Professional | | $1.29 | $1.29 | $1.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.63 / $3.47
| Professional | | $2.04 | $2.63 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.55 / $2.29 / $4.47
| Professional | | $1.55 | $2.29 | $4.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $85.11
| Facility | | $79.43 | $79.43 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.59 / $18.62 / $18.62
| Professional | | $12.59 | $18.62 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.51 / $2.51 / $2.51
| Professional | | $2.51 | $2.51 | $2.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.71 / $2.40 / $3.31
| Facility | | $0.71 | $2.40 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.29 / $1.29 / $2.45
| Professional | | $1.29 | $1.29 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.79 / $4.79 / $4.79
| Professional | | $4.79 | $4.79 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $3.24 / $5.01
| Professional | | $2.04 | $3.24 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.18 / $0.95 / $1.12
| Facility | | $0.18 | $0.95 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.95 / $1.12 / $2.51
| Professional | | $0.95 | $1.12 | $2.51 |