- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.74 / $1.74 / $1.99
| Facility | | $1.74 | $1.74 | $1.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.80 / $1.73 / $2.27
| Professional | | $0.80 | $1.73 | $2.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.64 / $1.64 / $3.00
| Facility | | $1.64 | $1.64 | $3.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.69 / $3.00 / $3.75
| Professional | | $1.69 | $3.00 | $3.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $3.07 / $4.22
| Professional | | $2.45 | $3.07 | $4.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.86 / $3.51 / $80.00
| Facility | | $1.86 | $3.51 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.06 / $1.38 / $3.73
| Professional | | $1.06 | $1.38 | $3.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.00 / $3.00 / $3.60
| Facility | | $3.00 | $3.00 | $3.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.36 / $3.32 / $5.74
| Professional | | $2.36 | $3.32 | $5.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.15 / $1.36 / $3.55
| Professional | | $1.15 | $1.36 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.46 / $2.46 / $2.46
| Facility | | $2.46 | $2.46 | $2.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.94 / $2.46 / $2.46
| Professional | | $1.94 | $2.46 | $2.46 |