- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.65 / $3.75 / $3.91
| Facility | | $1.65 | $3.75 | $3.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.34 / $1.65 / $3.94
| Professional | | $1.34 | $1.65 | $3.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.54 / $80.00 / $80.00
| Facility | | $2.54 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $2.57 / $17.67
| Professional | | $2.09 | $2.57 | $17.67 |
- 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
- $2.54 / $3.27 / $5.65
| Facility | | $2.54 | $3.27 | $5.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $3.45 / $5.79
| Professional | | $2.54 | $3.45 | $5.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.23 / $2.45
| Professional | | $2.00 | $2.23 | $2.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.61 / $2.83 / $2.90
| Facility | | $2.61 | $2.83 | $2.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $2.90 / $2.90
| Professional | | $2.54 | $2.90 | $2.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.41 / $2.54 / $4.69
| Facility | | $2.41 | $2.54 | $4.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.75 / $4.17
| Professional | | $2.41 | $2.75 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.31 / $2.47 / $3.19
| Professional | | $2.31 | $2.47 | $3.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.22 / $1.32 / $2.52
| Professional | | $1.22 | $1.32 | $2.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.55 / $2.02 / $2.02
| Professional | | $1.55 | $2.02 | $2.02 |