- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.08 / $1.33 / $2.35
| Facility | | $1.08 | $1.33 | $2.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.08 / $1.33 / $2.35
| Professional | | $1.08 | $1.33 | $2.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.25 / $1.55 / $3.33
| Professional | | $1.25 | $1.55 | $3.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.93 / $2.06 / $2.06
| Facility | | $1.93 | $2.06 | $2.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.06 / $2.06 / $2.06
| Professional | | $2.06 | $2.06 | $2.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.64 / $1.64 / $1.64
| Facility | | $1.64 | $1.64 | $1.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.39 / $1.39 / $1.87
| Professional | | $1.39 | $1.39 | $1.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.49 / $5.60 / $332.00
| Facility | | $2.49 | $5.60 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.44 / $1.79 / $4.41
| Professional | | $1.44 | $1.79 | $4.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.89 / $1.89 / $1.89
| Facility | | $1.89 | $1.89 | $1.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.80 / $1.80 / $2.06
| Professional | | $1.80 | $1.80 | $2.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.64 / $1.64 / $555.00
| Facility | | $1.64 | $1.64 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.39 / $1.64 / $3.71
| Professional | | $1.39 | $1.64 | $3.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.83 / $1.34 / $2.14
| Professional | | $0.83 | $1.34 | $2.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.80 / $1.80 / $1.80
| Facility | | $1.80 | $1.80 | $1.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.80 / $1.80 / $1.89
| Professional | | $1.80 | $1.80 | $1.89 |