- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.35 / $1.51 / $2.95
| Facility | | $1.35 | $1.51 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.35 / $1.58 / $2.95
| Professional | | $1.35 | $1.58 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.55 / $2.04 / $5.01
| Professional | | $1.55 | $2.04 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.42 / $2.60 / $2.60
| Facility | | $2.42 | $2.60 | $2.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.60 / $2.60 / $2.60
| Professional | | $2.60 | $2.60 | $2.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.87 / $1.87 / $2.08
| Facility | | $1.87 | $1.87 | $2.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.59 / $1.59 / $2.20
| Professional | | $1.59 | $1.59 | $2.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.12 / $7.02 / $332.00
| Facility | | $3.12 | $7.02 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.84 / $2.87 / $5.52
| Professional | | $1.84 | $2.87 | $5.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.35 / $2.35 / $2.35
| Facility | | $2.35 | $2.35 | $2.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $2.24 / $2.60
| Professional | | $2.24 | $2.24 | $2.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.87 / $1.87 / $555.00
| Facility | | $1.87 | $1.87 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.59 / $1.91 / $4.65
| Professional | | $1.59 | $1.91 | $4.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.04 / $1.55 / $2.69
| Professional | | $1.04 | $1.55 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.24 / $2.24 / $2.54
| Facility | | $2.24 | $2.24 | $2.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.24 / $2.24 / $2.35
| Professional | | $2.24 | $2.24 | $2.35 |