- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.42 / $3.22 / $3.37
| Facility | | $1.42 | $3.22 | $3.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.08 / $1.42 / $3.41
| Professional | | $1.08 | $1.42 | $3.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.20 / $80.00 / $80.00
| Facility | | $2.20 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $2.22 / $12.50
| Professional | | $1.78 | $2.22 | $12.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.51 / $1.51 / $1.60
| Facility | | $1.51 | $1.51 | $1.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.28 / $1.28 / $1.78
| Professional | | $1.28 | $1.28 | $1.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.12 / $2.66 / $4.54
| Facility | | $2.12 | $2.66 | $4.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.12 / $2.89 / $4.72
| Professional | | $2.12 | $2.89 | $4.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.73 / $1.93 / $2.12
| Professional | | $1.73 | $1.93 | $2.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.25 / $2.45 / $2.50
| Facility | | $2.25 | $2.45 | $2.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.25 / $2.50 / $2.50
| Professional | | $2.25 | $2.50 | $2.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.08 / $2.20 / $4.05
| Facility | | $2.08 | $2.20 | $4.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.08 / $2.38 / $3.61
| Professional | | $2.08 | $2.38 | $3.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.13 / $2.76
| Professional | | $2.00 | $2.13 | $2.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.98 / $1.07 / $2.02
| Professional | | $0.98 | $1.07 | $2.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.25 / $1.37 / $1.37
| Professional | | $1.25 | $1.37 | $1.37 |