- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.54 / $3.50 / $3.65
| Facility | | $1.54 | $3.50 | $3.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.17 / $1.54 / $3.65
| Professional | | $1.17 | $1.54 | $3.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.39 / $80.00 / $80.00
| Facility | | $2.39 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.84 / $2.39 / $18.23
| Professional | | $1.84 | $2.39 | $18.23 |
- 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
- $2.12 / $2.86 / $4.94
| Facility | | $2.12 | $2.86 | $4.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.12 / $3.05 / $4.96
| Professional | | $2.12 | $3.05 | $4.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.88 / $2.09 / $2.29
| Professional | | $1.88 | $2.09 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.09 / $2.27 / $2.73
| Facility | | $2.09 | $2.27 | $2.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.09 / $2.31 / $2.73
| Professional | | $2.09 | $2.31 | $2.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.27 / $2.39 / $4.43
| Facility | | $2.27 | $2.39 | $4.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $2.59 / $3.93
| Professional | | $2.27 | $2.59 | $3.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.17 / $2.31 / $2.87
| Professional | | $2.17 | $2.31 | $2.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.10 / $1.25 / $2.21
| Professional | | $1.10 | $1.25 | $2.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.25 / $1.66 / $1.66
| Professional | | $1.25 | $1.66 | $1.66 |