- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.69 / $2.49 / $5.45
| Facility | | $1.69 | $2.49 | $5.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.47 / $2.23 / $2.97
| Professional | | $1.47 | $2.23 | $2.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.59 / $3.64 / $9.31
| Facility | | $2.59 | $3.64 | $9.31 |
- 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
- $1.68 / $2.54 / $2.88
| Facility | | $1.68 | $2.54 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $2.54 / $2.54
| Professional | | $2.54 | $2.54 | $2.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.04 / $2.04 / $3.97
| Facility | | $2.04 | $2.04 | $3.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.73 / $1.73 / $1.73
| Professional | | $1.73 | $1.73 | $1.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.88 / $80.00 / $85.00
| Facility | | $6.88 | $80.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.88 / $16.88 / $25.43
| Professional | | $16.88 | $16.88 | $25.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.23 / $2.66 / $4.23
| Facility | | $2.23 | $2.66 | $4.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.86 / $3.22 / $3.39
| Professional | | $2.86 | $3.22 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.50 / $3.90 / $6.70
| Professional | | $2.50 | $3.90 | $6.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.25 / $2.66 / $4.24
| Facility | | $2.25 | $2.66 | $4.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.73 / $1.73 / $2.83
| Professional | | $1.73 | $1.73 | $2.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.20 / $1.56 / $2.06
| Professional | | $1.20 | $1.56 | $2.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.50 / $3.39 / $4.58
| Professional | | $1.50 | $3.39 | $4.58 |