- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.36 / $1.77 / $2.00
| Facility | | $1.36 | $1.77 | $2.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.36 / $1.79 / $2.35
| Professional | | $1.36 | $1.79 | $2.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.62 / $1.62 / $1.62
| Professional | | $1.62 | $1.62 | $1.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.56 / $3.34 / $7.70
| Facility | | $1.56 | $3.34 | $7.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.30 / $1.30 / $1.46
| Professional | | $1.30 | $1.30 | $1.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.73 / $2.73 / $2.73
| Facility | | $2.73 | $2.73 | $2.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.54 / $1.64 / $1.64
| Facility | | $1.54 | $1.64 | $1.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.39 / $1.39 / $1.74
| Professional | | $1.39 | $1.39 | $1.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.68 / $35.33 / $36.75
| Professional | | $18.68 | $35.33 | $36.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.75 / $2.02 / $2.73
| Facility | | $0.75 | $2.02 | $2.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.92 / $2.31 / $2.73
| Professional | | $0.92 | $2.31 | $2.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.75 / $1.95 / $2.73
| Facility | | $0.75 | $1.95 | $2.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.39 / $1.39 / $2.14
| Professional | | $1.39 | $1.39 | $2.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.97 / $1.26 / $1.66
| Professional | | $0.97 | $1.26 | $1.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.25 / $1.25 / $2.73
| Professional | | $1.25 | $1.25 | $2.73 |