- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.13 / $2.59 / $2.70
| Facility | | $1.13 | $2.59 | $2.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.85 / $1.13 / $2.70
| Professional | | $0.85 | $1.13 | $2.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.31 / $1.31 / $1.31
| Professional | | $1.31 | $1.31 | $1.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.76 / $80.00 / $80.00
| Facility | | $1.76 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.37 / $1.77 / $9.86
| Professional | | $1.37 | $1.77 | $9.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.21 / $1.21 / $1.28
| Facility | | $1.21 | $1.21 | $1.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.03 / $1.03 / $1.38
| Professional | | $1.03 | $1.03 | $1.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.69 / $2.13 / $3.79
| Facility | | $1.69 | $2.13 | $3.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.69 / $2.31 / $3.94
| Professional | | $1.69 | $2.31 | $3.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.38 / $1.54 / $1.69
| Professional | | $1.38 | $1.54 | $1.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.81 / $1.95 / $2.00
| Facility | | $1.81 | $1.95 | $2.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.81 / $1.95 / $2.00
| Professional | | $1.81 | $1.95 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.67 / $1.76 / $3.25
| Facility | | $1.67 | $1.76 | $3.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.67 / $1.90 / $2.88
| Professional | | $1.67 | $1.90 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.60 / $1.71 / $2.21
| Professional | | $1.60 | $1.71 | $2.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.79 / $0.85 / $1.62
| Professional | | $0.79 | $0.85 | $1.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.99 / $1.30 / $1.30
| Professional | | $0.99 | $1.30 | $1.30 |